Prospective Randomized Comparison of Chemoembolization with Doxorubicin-Eluting Beads and Bland Embolization with BeadBlock for Hepatocellular Carcinoma

Journal Article · Tue Jun 15 04:00:00 EDT 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9750-0· OSTI ID:21428987

Malagari, Katerina ^[1]; Pomoni, Mary ^[2]; Kelekis, Alexis ^[1]; Pomoni, Anastasia; Dourakis, Spyros ^[3]; Spyridopoulos, Themis ^[4]; Moschouris, Hippokratis ^[2]; Emmanouil, Emmanouil ^[4]; Rizos, Spyros ^[5]; Kelekis, Dimitrios ^[2]

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1. University of Athens, Imaging and Research Unit, Second Department of Radiology, Evgenidion Hospital (Greece)
2. University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece)
3. University of Athens, Department of Internal Medicine (Greece)
4. University of Athens, Second Department of Radiology (Greece)
5. Tzanion Hospital (Greece)

The purpose of this study was to evaluate the added role of a chemotherapeutic in transarterial chemoembolization (TACE) of intermediate-stage hepatocellular carcinoma (HCC). The issue is of major importance since, as suggested by recent evidence, hypoxia or incomplete devascularization of the tumor is a potent stimulator of angiogenesis, and there are not many papers supplying level one evidence confirming the value of a chemotherapeutic. The hypothesis was that since drug-eluting bead (DEB)-TACE is standardized and reproducible, a comparison with bland TACE can readily reveal the potential value of the chemotherapeutic. Two groups were randomized in this prospective study: group A (n = 41) was treated with doxorubicin DEB-TACE, and group B (n = 43) with bland embolization. Patients were randomized for tumor diameter. Patients were embolized at set time intervals (2 months), with a maximum of three embolizations. Tumor response was evaluated using the EASL criteria and {alpha}-fetoprotein levels. At 6 months a complete response was seen in 11 patients (26.8%) in the DEB-TACE group and in 6 patients (14%) in the bland embolization group; a partial response was achieved in 19 patients (46.3%) and 18 (41.9%) patients in the DEB-TACE and bland embolization groups, respectively. Recurrences at 9 and 12 months were higher for bland embolization (78.3% vs. 45.7%) at 12 months. Time to progression (TTP) was longer for the DEB-TACE group (42.4 {+-} 9.5 and 36.2 {+-} 9.0 weeks), at a statistically significant level (p = 0.008). In conclusion, DEB-TACE presents a better local response, fewer recurrences, and a longer TTP than bland embolization with BeadBlock. However, survival benefit and bland embolization with smaller particles must be addressed in future papers to better assess the clinical value.

• OSTI ID: 21428987
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 33; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ANOXIA
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTINEOPLASTIC DRUGS
CARCINOMAS
CHEMOTHERAPY
DISEASES
DOXORUBICIN
DRUGS
EMBOLI
HEPATOMAS
MEDICINE
NEOPLASMS
ORGANIC COMPOUNDS
THERAPY