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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

(A) Contrast-enhanced MR image before DEB TACE with viable enhancing neoplastic tissue. (B) Contrast-enhanced MR image after two DEB-TACE procedures showing a partial response (PR).
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f4-medscimonit-17-4-cr189: (A) Contrast-enhanced MR image before DEB TACE with viable enhancing neoplastic tissue. (B) Contrast-enhanced MR image after two DEB-TACE procedures showing a partial response (PR).

Mentions: Pre-treatment CT or MRI scans were used as a basis for documenting the initial findings (maximum of 4 weeks old). The minimum radiological requirement required for discussion in the tumour conference was either a biphasic contrast-enhanced CT or MRI with the specific hepatic contrast agent Gd-EOB-DTPA. In follow-up, the local response to therapy was documented 6–8 weeks after TACE using the same modality (Figures 3, 4). The response to therapy was assessed according to the criteria of the European Association for the Study of the Liver (EASL) by two experienced abdominal radiologists (more than 5 years experience) in consensus. The basis for this was comparison of the initial finding with the last documented examination of the patient. Thus, the therapeutic influence of the two TACE therapies was compared in the long-term course (mean 8.09 months, sd 6.6 months) of the HCC.


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)

(A) Contrast-enhanced MR image before DEB TACE with viable enhancing neoplastic tissue. (B) Contrast-enhanced MR image after two DEB-TACE procedures showing a partial response (PR).
© Copyright Policy
Related In: Results  -  Collection

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

f4-medscimonit-17-4-cr189: (A) Contrast-enhanced MR image before DEB TACE with viable enhancing neoplastic tissue. (B) Contrast-enhanced MR image after two DEB-TACE procedures showing a partial response (PR).
Mentions: Pre-treatment CT or MRI scans were used as a basis for documenting the initial findings (maximum of 4 weeks old). The minimum radiological requirement required for discussion in the tumour conference was either a biphasic contrast-enhanced CT or MRI with the specific hepatic contrast agent Gd-EOB-DTPA. In follow-up, the local response to therapy was documented 6–8 weeks after TACE using the same modality (Figures 3, 4). The response to therapy was assessed according to the criteria of the European Association for the Study of the Liver (EASL) by two experienced abdominal radiologists (more than 5 years experience) in consensus. The basis for this was comparison of the initial finding with the last documented examination of the patient. Thus, the therapeutic influence of the two TACE therapies was compared in the long-term course (mean 8.09 months, sd 6.6 months) of the HCC.

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