Drug-Eluting Beads Loaded With Doxorubicin (DEBDOX) Chemoembolisation Before Liver Transplantation for Hepatocellular Carcinoma: An Imaging/Histologic Correlation Study

Journal Article · Mon Jun 15 04:00:00 EDT 2015 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-014-0967-1· OSTI ID:22469931

Pauwels, Xavier; Azahaf, Mustapha ^[1]; Lassailly, Guillaume ^[2]; Sergent, Géraldine ^[1]; Buob, David ^[3]; Truant, Stéphanie; Boleslawski, Emmanuel ^[4]; Louvet, Alexandre ^[2]; Gnemmi, Vivianne ^[3]; Canva, Valérie; Mathurin, Philippe ^[2]; Pruvot, François-René ^[4]; Leteurtre, Emmanuelle ^[3]; others, and

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1. CHRU Lille, Hôpital Claude Huriez, Department of Digestive Diagnostic and Interventional Radiology (France)
2. CHRU Lille, Hôpital Claude Huriez, Department of Digestive Diseases and Nutrition (France)
3. CHRU Lille, Department of Pathology (France)
4. CHRU Lille, Hôpital Claude Huriez, Department of Digestive Surgery and Transplantation (France)

Purpose Most transplant centers use chemoembolisation as locoregional bridge therapy for hepatocellular carcinoma (HCC) before liver transplantation (LT). Chemoembolisation using beads loaded with doxorubicin (DEBDOX) is a promising technique that enables delivery of a large quantity of drugs against HCC. We sought to assess the imaging–histologic correlation after DEBDOX chemoembolisation.Materials and Methods All consecutive patients who had undergone DEBDOX chemoembolisation before receiving liver graft for HCC were included. Tumour response was evaluated according to Response Evaluation Criteria in Solid Tumours (RECIST) and modified RECIST (mRECIST) criteria. The result of final imaging made before LT was correlated with histological data to predict tumour necrosis.ResultsTwenty-eight patients underwent 43 DEBDOX procedures for 45 HCC. Therapy had a significant effect as shown by a decrease in the mean size of the largest nodule (p = 0.02) and the sum of viable part of tumour sizes according to mRECIST criteria (p < 0.001). An objective response using mRECIST criteria was significantly correlated with mean tumour necrosis ≥90 % (p = 0.03). A complete response using mRECIST criteria enabled accurate prediction of complete tumour necrosis (p = 0.01). Correlations using RECIST criteria were not significant.ConclusionOur data confirm the potential benefit of DEBDOX chemoembolisation as bridge therapy before LT, and they provide a rational basis for new studies focusing on recurrence-free survival after LT. Radiologic evaluation according to mRECIST criteria enables accurate prediction of tumour necrosis, whereas RECIST criteria do not.

• OSTI ID: 22469931
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 38; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
DOXORUBICIN
FORECASTING
GRAFTS
HEPATOMAS
LIVER
NECROSIS
PATIENTS
THERAPY
WHO