Transarterial Chemoembolization With Cisplatin as Second-Line Treatment for Hepatocellular Carcinoma Unresponsive to Chemoembolization With Epirubicin-Lipiodol Emulsion

Journal Article · Wed Feb 15 00:00:00 EST 2012 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-0086-6· OSTI ID:21608606

Maeda, Noboru; Osuga, Keigo; Higashihara, Hiroki; Tomoda, Kaname ^[1]; Mikami, Koji ^[2]; Nakazawa, Tetsuro ^[3]; Nakamura, Hironobu ^[4]; Tomiyama, Noriyuki ^[1]

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1. Osaka University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology (Japan)
2. Suita Municipal Hospital, Department of Radiology (Japan)
3. National Cardiovascular Center, Department of Radiology (Japan)
4. Saito Yukoukai Hospital (Japan)

Purpose: The purpose of this retrospective study was to investigate the efficacy of transarterial chemoembolization (TACE) using cisplatin as a second-line treatment for advanced hepatocellular carcinoma (HCC) unresponsive to TACE using epirubicin-Lipiodol emulsion at our institution. Materials and Methods: Between January 2006 and March 2009, 51 patients with unresectable HCC underwent TACE using cisplatin. All patients had shown persistent viable tumor or tumor progression after at least 2 sessions of TACE using epirubicin-Lipiodol emulsion. TACE procedures consisted of arterial injection of a mixture of Lipiodol and cisplatin (30-100 mg [mean 57 {+-} 21]) (n = 29) or arterial infusion of cisplatin (30-100 mg [mean 87 {+-} 19]) solution (n = 22) followed by injection of 1-mm porous gelatin particles. Early tumor response was assessed by contrast-enhanced computed tomography (CT) according to Response Evaluation Criteria in Solid Tumors (RECIST) and European Association for the Study of the Liver (EASL) criteria. Overall survival and progression-free survival was calculated using the Kaplan-Meier method. Toxicity was assessed according to NCI-CTCAE version 3 criteria. Results: Response rates were 11.8 and 27.5% by RECIST and EASL criteria, respectively. Overall survival rates were 61.9, 48.2, and 28.9% at 1, 2, and 3 years, respectively, and the median survival time was 15.4 months. Progression-free survival rate was 35.2% at 1 year, and median progression-free survival time was 3.1 months. No major complications were observed, and the occurrence of postembolization syndrome was minimal. Grade 3 to 4 toxicities included thrombocytopenia (5.8%), increased aspartate aminotransferase (AST) level (35.3%), and increased alanine aminotransferase (ALT) level (23.5%). Conclusions: witching the TACE anticancer drug from epirubicin to cisplatin might be the feasible option for advanced HCC, even when considered resistant to the initial form of TACE.

• OSTI ID: 21608606
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 35, Issue 1; Other Information: DOI: 10.1007/s00270-010-0086-6; Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); 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
ALANINES
ANTINEOPLASTIC DRUGS
COMPUTERIZED TOMOGRAPHY
EMULSIONS
EVALUATION
GELATIN
HEPATOMAS
INJECTION
LIPIODOL
LIVER
PATIENTS
POROUS MATERIALS
SOLIDS
SURVIVAL TIME
TOXICITY
AMINO ACIDS
BODY
CARBOXYLIC ACIDS
CARCINOMAS
COLLOIDS
CONTRAST MEDIA
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DISPERSIONS
DRUGS
GLANDS
INTAKE
MATERIALS
NEOPLASMS
OILS
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANS
OTHER ORGANIC COMPOUNDS
PROTEINS
TOMOGRAPHY