Safety and efficacy of balloon‐occluded transcatheter arterial chemoembolization using miriplatin for hepatocellular carcinoma

Arai, Hajime; Abe, Takehiko; Takayama, Hisashi; Toyoda, Mitsuo; Ueno, Takashi; Kakizaki, Satoru; Sato, Ken

doi:10.1111/hepr.12403

Cited by 45 publications

(67 citation statements)

References 6 publications

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“…This is possibly because the number of patients in our EPIR-C-TACE group who could be treated with superselective TACE might have been fewer than in previous reports. The local control rate after MPT-B-TACE in the present study (median time to local recurrence, 8.3 M) might be comparable with previous reports regarding C-TACE using MPT and EPIR [14,32], but the present data tended to be lower than in previous reports regarding MPT-B-TACE [28,33,34]. This might be possibly caused by patient and tumor characteristics.…”

Section: Discussionsupporting

confidence: 85%

“…The rate of IR in the present study tended to be lower than that in Miyayama's report. Recent studies regarding MPT-B-TACE reported a high objective response rate, including TE3 and TE4, after treatment [28,29]. The main strength of B-TACE might be the forceful injection of MLS after its accumulation in the treated arteries.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, most AEs tended to be fewer in the MPT-B-TACE group than in the EPIR-C-TACE group. MPT is considered to cause few systemic adverse reactions because it remains locally in tumors for a long period of time and it is transferred minimally to the systemic circulation [28,30,31]. Thus, even if local drug uptake is enhanced by B-TACE, a small systemic effect may be possible.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases

Hirakawa

Yamanouchi

Tsuruta

et al. 2017

Interventional Radiology

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Purpose: This study aimed to retrospectively compare the local control and safety of microballoonoccluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and of conventional TACE (C-TACE) using epirubicin (EPIR) for hepatocellular carcinoma (HCC).Materials and Methods: Thirty-nine patients (24 men, 15 women; mean age, 73.4 years) were treated using B-TACE with MPT (MPT-B-TACE group). As a historical comparison, 23 patients (13 men, 10 women; mean age, 72.2 years) who were treated using C-TACE with EPIR (EPIR-C-TACE group) were investigated. The therapeutic effect within 2 weeks after treatment was compared between the groups based on the Response Evaluation Criteria in Cancer of the Liver (RECICL), and time to local recurrence was compared based on the Kaplan-Meier method and log-rank tests. The side effects were compared based on the Common Terminology Criteria for Adverse Events (ver. 4.0).Results: No significant differences were noted in patients' characteristics between the groups. The overall incidence of postembolization syndrome was significantly lower in the MPT-B-TACE group than in the EPIR-C-TACE group (p<0.05), but two cases in the MPT-B-TACE group developed grade 2 cholecystitis. Based on the RECICL, the objective response rate, including TE4 and TE3, within 2 weeks after treatment was significantly higher in the MPT-B-TACE group (89.7%) than in the EPIR-C-TACE group (78.3%). Overall, local recurrence was significantly less frequent in the MPT-B-TACE group than in the EPIR-C-TACE group (p=0.02).Conclusion: MPT-B-TACE was associated with a higher objective response rate and lower local recurrence rate than EPIR-C-TACE without a significant increase in adverse effects.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases

Hirakawa

Yamanouchi

Tsuruta

et al. 2017

Interventional Radiology

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“…When obvious progression is shown by imaging, prompt switching of the therapeutic modality is recommended. In other words, attempts to perform a few additional TACE procedures by changing catheter devises such as a balloon catheter [21], a chemoagent, or embolization switching devises (e.g. drug-eluting beads) [22] can be considered until the tumor marker score increases to ≥2 in cases considered as having stable disease or with a slow progression in imaging findings.…”

Section: Discussionmentioning

confidence: 99%

Tumor Markers AFP, AFP-L3, and DCP in Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization

Hiraoka¹,

Ishimaru²,

Kawasaki

et al. 2015

Oncology

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Background/Aim: We examined tumor marker levels to assess in more detail transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). Materials and Methods: We enrolled patients treated from 2000 to 2011 for HCC beyond the Milan criteria who had good hepatic reserve function (Child-Pugh A) and no portal vein thrombosis or metastases (n = 154). The modified criteria for being TACE-refractory according to the Liver Cancer Study Group of Japan (m-LCSGJ), from which the tumor marker item was excluded, and the Assessment for Retreatment with TACE (ART) score were used for determining whether the HCC was TACE refractory. α-Fetoprotein ≥100 ng/ml, fucosylated α-fetoprotein ≥10%, and des-gamma-carboxy prothrombin ≥100 mAU/ml were used to define whether tumor markers were positive. We added up the number of positive tumor markers as a prognostic score to assess in more detail the evaluation of TACE-refractory HCC. Results: In order to divide the patients into a refractory and nonrefractory group, the m-LCSGJ criteria [mean survival time (MST) 27.1 vs. 49.9 months; p < 0.001] were superior to the ART score (MST 22.0 vs. 35.1 months; p = 0.051). In the refractory group according to the m-LCSGJ criteria, the patients with a low score of positive tumor markers (<2) after 2 sessions of TACE (n = 36) showed a better prognosis than the others (n = 72) (MST 37.7 vs. 23.2 months; p = 0.014). Conclusion: Patients being nonrefractory according to the m-LCSGJ criteria had a better response, and using the number of tumor markers (≥2) is an easy method for predicting the response to TACE and for a more detailed evaluation of TACE-refractory HCC.

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“…Irie et al [12] reported that better lipiodol deposition was obtained by performing selective TACE while decreasing the inflow resistance of intratumoral blood flow using a microballoon catheter, called ‘balloon-occluded TACE' (b-TACE). There are reports that b-TACE has the potential to improve cancer nodule control locally, compared with c-TACE [13,14]. …”

Section: Introductionmentioning

confidence: 99%

Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience

Minami

Minami²,

Chishina³

et al. 2015

Oncology

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Objective: To investigate whether balloon-occluded transcatheter arterial chemoembolization (b-TACE) can produce a more dense accumulation of iodized oil in various stages of hepatocellular carcinoma (HCC), from single to uncountable, to overcome inferior local control. Materials and Methods: We studied 27 patients with HCC, including single to uncountable multiple lesions, who underwent b-TACE between August 2013 and April 2015. Dynamic CT was performed at baseline and 1-3 months after b-TACE. The treatment effect (TE) after b-TACE was evaluated using the Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan. Results: In the countable HCC group, contrast-enhanced CT demonstrated RECICL TE4 in 43.8% (14/32), TE3 in 12.5% (4/32), TE2 in 37.5% (12/32), and TE1 in 6.3% (2/32) of patients. For the TACE-naïve cohort, the objective response rate was 52.9%. The objective response rate was 60% for the previously TACE-treated cohort. In the uncountable multiple HCC group, the objective response rate was 0% (0/10), with progressive disease in 90% (9/10) of patients. Conclusion: Our observations suggested that b-TACE did not reduce the efficacy of retreatment for HCC with an insufficient outcome from conventional TACE, but it could not improve the efficacy of treatment for uncountable multiple HCCs.

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Safety and efficacy of balloon‐occluded transcatheter arterial chemoembolization using miriplatin for hepatocellular carcinoma

Abstract: Compared with C-TACE, B-TACE significantly improved cancer nodule control, and it was satisfactory in terms of safety. B-TACE is an effective procedure that enhances the effects of catheterization with miriplatin.

Cited by 45 publications

References 6 publications

Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases

Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases

Tumor Markers AFP, AFP-L3, and DCP in Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization

Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience

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