Transcatheter Treatment of Hepatocellular Carcinoma with Doxorubicin-loaded DC Bead (DEBDOX): Technical Recommendations

Journal Article · Mon Oct 15 00:00:00 EDT 2012 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-011-0287-7· OSTI ID:22066546

Lencioni, Riccardo ^[1]; Baere, Thierry de ^[2]; Burrel, Marta ^[3]; Caridi, James G ^[4]; Lammer, Johannes ^[5]; Malagari, Katerina ^[6]; Martin, Robert C. G. ^[7]; O'Grady, Elizabeth ^[8]; Real, Maria Isabel ^[3]; Vogl, Thomas J ^[9]; Watkinson, Anthony ^[10]; Geschwind, Jean-Francois H ^[11]

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1. Pisa University Hospital, University of Pisa, Division of Diagnostic Imaging and Intervention (Italy)
2. Institut Gustav-Roussy, Department of Interventional Radiology (France)
3. Barcelona Clinic for Liver Cancer, Hospital Clinic, Department of Radiology (Spain)
4. University of Florida, Division of Interventional Radiology (United States)
5. Medical University of Vienna, Department of Interventional Radiology (Austria)
6. University of Athens, Department of Radiology (Greece)
7. University of Louisville, Division of Surgical Oncology (United States)
8. University Hospital Aintree, Department of Radiology (United Kingdom)
9. University of Frankfurt, Department of Radiology (Germany)
10. Royal Devon and Exeter Hospital, Department of Interventional Radiology (United Kingdom)
11. Johns Hopkins University, Division of Interventional Radiology (United States)

Tranarterial chemoembolization (TACE) has been established by a meta-analysis of randomized controlled trials as the standard of care for nonsurgical patients with large or multinodular noninvasive hepatocellular carcinoma (HCC) isolated to the liver and with preserved liver function. Although conventional TACE with administration of an anticancer-in-oil emulsion followed by embolic agents has been the most popular technique, the introduction of embolic drug-eluting beads has provided an alternative to lipiodol-based regimens. Experimental studies have shown that TACE with drug-eluting beads has a safe pharmacokinetic profile and results in effective tumor killing in animal models. Early clinical experiences have confirmed that drug-eluting beads provide a combined ischemic and cytotoxic effect locally with low systemic toxic exposure. Recently, the clinical value of a TACE protocol performed by using the embolic microsphere DC Bead loaded with doxorubicin (DEBDOX; drug-eluting bead doxorubicin) has been shown by randomized controlled trials. An important limitation of conventional TACE has been the inconsistency in the technique and the treatment schedules. This limitation has hampered the acceptance of TACE as a standard oncology treatment. Doxorubicin-loaded DC Bead provides levels of consistency and repeatability not available with conventional TACE and offers the opportunity to implement a standardized approach to HCC treatment. With this in mind, a panel of physicians took part in a consensus meeting held during the European Conference on Interventional Oncology in Florence, Italy, to develop a set of technical recommendations for the use of DEBDOX in HCC treatment. The conclusions of the expert panel are summarized.

• OSTI ID: 22066546
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 35, Issue 5; Other Information: Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2011 The Author(s); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DOXORUBICIN
EMULSIONS
HEPATOMAS
LIPIODOL
LIVER
PATIENTS
RADIOLOGY