Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma

Abstract

OBJECTIVE:To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with embospheres for the treatment of unresectable hepatocellular carcinoma (HCC). METHODS:Patients with unresectable HCC who were treated with TACE followed by embosphere treatment (Embo-TACE) or conventional TACE (cTACE) between May 2010 and March 2014 were retrospectively included in this study. The Embo-TACE group received lipiodol and chemotherapeutic agent emulsion, followed by embospheres. The cTACE group received lipiodol and chemotherapeutic agent emulsion, followed by gelatin sponge pellets. Time to progression (TTP), overall survival (OS), overall response rate (ORR), and safety were compared between the two groups. Univariate and multivariate regression analyses of the factors affecting survival were conducted. RESULTS:The median TTP and OS in the Embo-TACE group were significantly longer than those in the cTACE group (TPP: 7.0 months vs 5.4 months, P = 0.035; OS: 15 months vs 12 months, P = 0.032). Seven days after the first TACE treatment, alanine aminotransferase level was higher in the cTACE group than in the Embo-TACE group (P = 0.015). The ORR did not significantly differ between the two groups (P = 0.827). Additional therapy and local responses one month after the first TACE treatment were associated with OS. CONCLUSIONS:Embo-TACE resulted in a significant improvement in TTP and OS for patients with unresectable HCC, compared with cTACE. Furthermore, Embo-TACE was better tolerated. Additional therapy and local responses one month after the first TACE were independent prognostic factors for OS.

The Effect of Transarterial Chemoembolization in Combination With Kang’ai Injection on Patients With Intermediate Stage Hepatocellular Carcinoma: A Prospective Study

“…Previous studies reported that the 1-, 2-, and 3-year survival rates ranged 57% to 82%, 31% to 63%, and 26% to 47%, respectively, 11 , 22 the median survival periods between 17.4 and 34 months, 9 , 10 , 23 and the median TTP periods from 4.9 to 7.9 months. 23 - 25 In the present study, we clearly demonstrated that adding adjuvant therapy of KA injection to TACE improved the efficacy of TACE per se in the treatment of intermediate stage HCC in BCLC classification system. Patients receiving both TACE and KA injections had significantly prolonged OS and TTP, higher survival rates, and reduced incidence of postembolization syndrome as well as lower frequencies of intrahepatic and extrahepatic metastases, when compared with those receiving only TACE.…”

Efficacy and Safety of Transarterial Chemoembolization with a Three-Stage Mixed Chemoembolic Regimen for Large Unresectable Hepatocellular Carcinoma

“…However, it is unfortunate that only 20% of patients in China can benefit from surgery due to late-stage diagnosis and excessive tumor burden. 4 …”

Efficacy and Safety of DEB-TACE for Patients With Hepatocellular Carcinoma With the Largest Tumor Diameter ≥7 cm

“…However, the traditional TACE with lipiodol as the embolization agent don't achieve the ideal curative e cacy. It often requires repeated embolization to achieve a better treatment response, and multiple cycles of TACE will cause hepatic blood vessel and liver dysfunction, which has a bad effect on the next embolization treatment [8]. The CalliSpheres drug-elutted beads can not only load and release chemotherapeutics slowly in local area but can also embolize the tumor feeding vessels permanently [9].…”