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Transarterial Chemoembolization of Child-A hepatocellular carcinoma: drug-eluting bead TACE (DEB TACE) vs. TACE with cisplatin/lipiodol (cTACE).

Wiggermann P, Sieron D, Brosche C, Brauer T, Scheer F, Platzek I, Wawrzynek W, Stroszczynski C - Med. Sci. Monit. (2011)

Bottom Line: The choice of TACE procedure (DEB TACE/cTACE) had no significant impact on therapy-associated complications.After DEB-TACE mean survival was significantly prolonged with 651 ± 76 days vs. 414 ± 43 days for cTACE (p=0.01).Associated with a similar safety profile and an at least comparable tumour response, the DEB-TACE is a method of treatment for HCC that has the potential to improve mean survival compared to cTACE with Cisplatin/Lipiodol.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dresden University of Technology, Dresden, Germany. openphw@googlemail.com

ABSTRACT

Background: This study is an outcome evaluation of the Drug-Eluting-Bead-Chemoembolization (DEB TACE) compared to conventional TACE (cTACE) with Cisplation and Lipiodol in patients with hepatocellular carcinoma (HCC) and Child-Pugh A Cirrhosis.

Material/methods: A comparison of interventional therapy with either cTACE or DEB-TACE of 22 patients each with unresectable HCC and Child-Pugh A Cirrhosis was carried out. A comparison of therapy-associated complications, tumour response rates and mean survival was performed. Tumour response was evaluated in accordance with the European Association for the Study of the Liver (EASL) response criteria by two radiologists in consensus reading.

Results: The choice of TACE procedure (DEB TACE/cTACE) had no significant impact on therapy-associated complications. Objective Response (OR, complete response + partial response) for DEB-TACE was 22.7%; a further 68.2% was stable disease (SD). The respective response rates for the cTACE were OR 22.7 and SD 31.8%. Thus disease control was not significantly increased for DEB TACE (p=0.066). After DEB-TACE mean survival was significantly prolonged with 651 ± 76 days vs. 414 ± 43 days for cTACE (p=0.01).

Conclusions: Associated with a similar safety profile and an at least comparable tumour response, the DEB-TACE is a method of treatment for HCC that has the potential to improve mean survival compared to cTACE with Cisplatin/Lipiodol.

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Related in: MedlinePlus

Distribution of TACE procedures per patient: cTACE Mean 1.95±1.62, min 1, max 7, Sum 49; DEB TACE Mean 2.09±1.15, min 1, max 4, Sum 46.
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f1-medscimonit-17-4-cr189: Distribution of TACE procedures per patient: cTACE Mean 1.95±1.62, min 1, max 7, Sum 49; DEB TACE Mean 2.09±1.15, min 1, max 4, Sum 46.

Mentions: In the period 2003 to 2008, 74 consecutive patients with histologically confirmed HCC were treated by TACE in our institution. 44 of these patients were included in this retrospective evaluation. All patients with an advanced stage of liver cirrhosis (Child-Pugh B or C) were excluded, as advanced hepatic failure is the critical prognostic factor for survival in these patients [16,17]. Moreover, patients with embolization alone (TAE), combined therapy (e.g. RFA+TACE), and patients who had partial liver resection or liver transplantation after TACE were not included in this study. Patients who had both cTACE and DEB-TACE were not included either. 37 men and 7 women with HCC at an advanced inoperable stage were included (Table 1). The average age at the time of histological confirmation (first diagnosis) of the HCC was 69.02±8.11 years (min 45.6/max 84.7). All of the patients had Child-A cirrhosis. 13 cases of cirrhosis were of toxic nutritional aetiology (ethanol) and 5 were due to infection. The remaining 26 patients had cryptogenic cirrhosis. The patients had either one or more administrations of cTACE (n=22), or were given one or more DEB-TACE treatments (n=22); 89 sessions in total (Figure 1).


Transarterial Chemoembolization of Child-A hepatocellular carcinoma: drug-eluting bead TACE (DEB TACE) vs. TACE with cisplatin/lipiodol (cTACE).

Wiggermann P, Sieron D, Brosche C, Brauer T, Scheer F, Platzek I, Wawrzynek W, Stroszczynski C - Med. Sci. Monit. (2011)

Distribution of TACE procedures per patient: cTACE Mean 1.95±1.62, min 1, max 7, Sum 49; DEB TACE Mean 2.09±1.15, min 1, max 4, Sum 46.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539521&req=5

f1-medscimonit-17-4-cr189: Distribution of TACE procedures per patient: cTACE Mean 1.95±1.62, min 1, max 7, Sum 49; DEB TACE Mean 2.09±1.15, min 1, max 4, Sum 46.
Mentions: In the period 2003 to 2008, 74 consecutive patients with histologically confirmed HCC were treated by TACE in our institution. 44 of these patients were included in this retrospective evaluation. All patients with an advanced stage of liver cirrhosis (Child-Pugh B or C) were excluded, as advanced hepatic failure is the critical prognostic factor for survival in these patients [16,17]. Moreover, patients with embolization alone (TAE), combined therapy (e.g. RFA+TACE), and patients who had partial liver resection or liver transplantation after TACE were not included in this study. Patients who had both cTACE and DEB-TACE were not included either. 37 men and 7 women with HCC at an advanced inoperable stage were included (Table 1). The average age at the time of histological confirmation (first diagnosis) of the HCC was 69.02±8.11 years (min 45.6/max 84.7). All of the patients had Child-A cirrhosis. 13 cases of cirrhosis were of toxic nutritional aetiology (ethanol) and 5 were due to infection. The remaining 26 patients had cryptogenic cirrhosis. The patients had either one or more administrations of cTACE (n=22), or were given one or more DEB-TACE treatments (n=22); 89 sessions in total (Figure 1).

Bottom Line: The choice of TACE procedure (DEB TACE/cTACE) had no significant impact on therapy-associated complications.After DEB-TACE mean survival was significantly prolonged with 651 ± 76 days vs. 414 ± 43 days for cTACE (p=0.01).Associated with a similar safety profile and an at least comparable tumour response, the DEB-TACE is a method of treatment for HCC that has the potential to improve mean survival compared to cTACE with Cisplatin/Lipiodol.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dresden University of Technology, Dresden, Germany. openphw@googlemail.com

ABSTRACT

Background: This study is an outcome evaluation of the Drug-Eluting-Bead-Chemoembolization (DEB TACE) compared to conventional TACE (cTACE) with Cisplation and Lipiodol in patients with hepatocellular carcinoma (HCC) and Child-Pugh A Cirrhosis.

Material/methods: A comparison of interventional therapy with either cTACE or DEB-TACE of 22 patients each with unresectable HCC and Child-Pugh A Cirrhosis was carried out. A comparison of therapy-associated complications, tumour response rates and mean survival was performed. Tumour response was evaluated in accordance with the European Association for the Study of the Liver (EASL) response criteria by two radiologists in consensus reading.

Results: The choice of TACE procedure (DEB TACE/cTACE) had no significant impact on therapy-associated complications. Objective Response (OR, complete response + partial response) for DEB-TACE was 22.7%; a further 68.2% was stable disease (SD). The respective response rates for the cTACE were OR 22.7 and SD 31.8%. Thus disease control was not significantly increased for DEB TACE (p=0.066). After DEB-TACE mean survival was significantly prolonged with 651 ± 76 days vs. 414 ± 43 days for cTACE (p=0.01).

Conclusions: Associated with a similar safety profile and an at least comparable tumour response, the DEB-TACE is a method of treatment for HCC that has the potential to improve mean survival compared to cTACE with Cisplatin/Lipiodol.

Show MeSH
Related in: MedlinePlus