Local Therapeutic Results of Computed Tomography-Guided Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Results of 265 Tumors in 79 Patients

Hayashi, Keiji; Ina, Hiroyasu; Tezuka, Mikio; Okada, Yoichi; Irie, Tetsuya

doi:10.1007/s00270-007-9169-4

Cited by 20 publications

(16 citation statements)

References 31 publications

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“…However, it was mostly used at a sub-subsegmental artery or a more distal artery. Third, the local tumor control rate was lower than that in previous reports (5,11,12). We think our TACE may be incomplete even though we could insert a microcatheter into a distal position.…”

Section: Discussioncontrasting

confidence: 58%

Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2012

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Section: Discussioncontrasting

confidence: 58%

Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2012

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“…However, local control after TACE is inferior to that achieved after curative treatment. In a study of TACE involving 265 patients with HCC, the 3‐year local control rate for those who had tumors with complete and incomplete lipiodol accumulation was 41% and 9%, respectively . In addition, it has been reported that noncompact lipiodol accumulation after TACE is a risk factor for early local recurrence .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, patients with solitary HCC are not always suitable for these treatments, presumably because of poor liver function and/or tumor location. In such situations, the patient usually received transarterial chemoembolization (TACE); however, local control after TACE is unsatisfactory …”

Section: Introductionmentioning

confidence: 99%

Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation

Takeda

Sanuki

Tsurugai

et al. 2016

Cancer

171

140

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BACKGROUND: Curative treatment options for patients with early stage hepatocellular carcinoma (HCC) include resection, liver transplantation, and percutaneous ablation therapy. However, even patients with solitary HCC are not always amenable to these treatments. The authors prospectively investigated the clinical outcomes of patients who received stereotactic body radiotherapy (SBRT) for solitary HCC. METHODS: A phase 2 study involving SBRT and optional transarterial chemoembolization (TACE) was conducted in patients with Child-Pugh grade A or B and underlying, solitary HCC (greatest tumor dimension, 4 cm) who were unsuitable candidates for resection and radiofrequency ablation. The prescription dose was 35 to 40 grays in 5 fractions. The primary endpoint was 3-year local tumor control. RESULTS: From 2007 to 2012, 101 patients were enrolled, and 90 were evaluable with a median follow-up of 41.7 months (range, 6.8-96.2 months). Thirty-two patients were treatment-na€ ıve, 20 were treated for newly diagnosed intrahepatic failure, and 38 were treated for residual or recurrent HCC as salvage therapy. Thirty-two patients did not receive TACE, 48 received insufficient TACE, and 10 attained full lipiodol accumulation. The 3-year local control rate was 96.3%, the 3-year liver-related causespecific survival rate was 72.5%, and the overall survival rate was 66.7%. Grade 3 laboratory abnormalities were observed in 6 patients, and 8 patients had Child-Pugh scores that worsened by 2 points. CONCLUSIONS: SBRT achieved high local control and overall survival with feasible toxicities for patients with solitary HCC, despite rather stringent conditions. SBRT can be effective against solitary HCC in treatment-naive, intrahepatic failure, residual disease, and recurrent settings, taking advantage of its distinctive characteristics. Cancer 2016;122:2041-9. V C 2016 American Cancer Society. KEYWORDS: curative treatment, hepatocellular carcinoma (HCC), noninvasive treatment, stereotactic body radiotherapy (SBRT). INTRODUCTIONCurative treatment options for patients with early stage hepatocellular carcinoma (HCC) are resection, liver transplantation (LT), and percutaneous ablation therapy. 1 However, <30% of patients are eligible for these treatments. 2 In addition, patients with solitary HCC are not always suitable for these treatments, 3 presumably because of poor liver function and/or tumor location. In such situations, the patient usually received transarterial chemoembolization (TACE) 1 ; however, local control after TACE is unsatisfactory. 4,5 Stereotactic body radiotherapy (SBRT) is a high-precision, conformal, external-beam radiation technique that ablates the target at extracranial sites using hypofractionated, high-dose radiation while sparing surrounding normal tissues. Currently, SBRT is considered a treatment option for patients with medically inoperable, early stage, nonsmall cell lung cancer. 6 Findings from retrospective series of patients with small HCC who received SBRT indicated high local control rates from 99% to 100...

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“…In the same study, it was found that lesion morphology displayed significance for recurrence-free survival (p = 0.014%). Reported local recurrence rates for c-TACE at 1 and 3 years post baseline embolization include: 20 to 53.2% [43,44], 50.2 to 71.7% [43] for segmental embolizations that rise to 58 to 78% for nonsegmental embolization [43].…”

Section: Local Response Survival and Safety Profilementioning

confidence: 99%

Chemoembolization of hepatocellular carcinoma with HepaSphere™

et al. 2015

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This review discusses the current data on Hepasphere™ in the treatment of hepatocellular carcinoma. HepaSphere is a drug-loadable microsphere that can be bound with doxorubicin, epirubicin, cisplatin or oxaliplatin. and studies confirm lower systemic exposure to the drug and fewer systemic doxorubicin-related side effects. Studies suggest that this technique is better tolerated than conventional lipiodol-based chemoembolization (c-TACE). In intermediate and early stage hepatocellular carcinoma - nonresponsive to curative treatments - complete response and partial response rates range from 22.2 to 48% and 43.7 to 51%, respectively. Studies with survival as an end-point are needed and head-to-head comparisons with other drug-eluting beads are necessary.

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Local Therapeutic Results of Computed Tomography-Guided Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Results of 265 Tumors in 79 Patients

Abstract: Local therapeutic results of single new lesions were better than those of multiple new lesions, and the local therapeutic effect of TACE was not affected by the number of treatments on the basis of patient, tumor location, or tumor size.

Cited by 20 publications

References 31 publications

Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for hepatocellular carcinoma

Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for hepatocellular carcinoma

Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation

Chemoembolization of hepatocellular carcinoma with HepaSphere™

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