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Title: Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile

Abstract

PurposeTo evaluate the short-term safety and efficacy of the new generation of 70–150 µm drug-eluting beads (M1 DEB) in patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) as a primary therapy or as a bridge to liver transplantation (LT).MethodsForty-five consecutive patients underwent TACE with M1 DEB loaded with doxorubicin (DEBDOX/M1). Clinical data were recorded at 12, 24, and 48 h, 7 and 30 days after treatment. Response was assessed by computed tomographic scan according to the modified response evaluation criteria in solid tumors criteria, and a second DEBDOX/M1 TACE was scheduled within 6 weeks in case of a noncomplete response.ResultsAll patients had well-compensated cirrhosis (97.7 % Child A, 44.4 % hepatitis C virus, median age 61 years). Twenty patients (44.4 %) had Barcelona Clinic for Liver Cancer class B disease; the median number of nodules and their sum of diameters were 2 (range 1–6) and 43 mm (range 10–190), respectively. The mean number of TACE procedures per patient was 1.4. Objective response rate (complete + partial response) was 77.7 % with a median time to best response of 3 months (95 % confidence interval 2–4). In 13 patients, DEBDOX/M1 TACE served as a bridge/downstaging to LT/surgery. Pathology showed that more than 90 % necrosis was achieved in 10 of 28 nodules. DEBDOX/M1 TACE was wellmore » tolerated, and the grade 3/4 adverse event rate was low (1 of 65 procedures).ConclusionDEBDOX/M1 TACE is an effective procedure with a favorable safety profile and promising results in terms of objective response rate, tumor downstaging, and necrosis.« less

Authors:
;  [1]; ;  [2]; ; ; ;  [1];  [2];  [3];  [1];  [2]
  1. Fondazione Istituto Tumori, Department of Radiology (Italy)
  2. Fondazione Istituto Tumori, Department of Liver Surgery and Transplant (Italy)
  3. Fondazione Istituto Tumori, Department of Pathology (Italy)
Publication Date:
OSTI Identifier:
22470096
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRIDGES; CHILDREN; DOXORUBICIN; EVALUATION; HEPATOMAS; HYDROGEN 7; LIVER; NECROSIS; PATHOLOGY; PATIENTS; SAFETY; SOLIDS; SURGERY; THERAPY; VIRUSES

Citation Formats

Spreafico, Carlo, E-mail: carlo.spreafico@istitutotumori.mi.it, Cascella, Tommaso, E-mail: tommaso.cascella@istitutotumori.mi.it, Facciorusso, Antonio, E-mail: antonio.facciorusso@istitutotumori.mi.it, Sposito, Carlo, E-mail: carlo.sposito@istitutotumori.mi.it, Rodolfo, Lanocita, E-mail: rodolfo.lanocita@istitutotumori.mi.it, Morosi, Carlo, E-mail: carlo.morosi@istitutotumori.mi.it, Civelli, Enrico M., E-mail: enrico.civelli@istitutotumori.mi.it, Vaiani, Marta, E-mail: marta.vaiani@istitutotumori.mi.it, Bhoori, Sherrie, E-mail: sherrie.bhoori@istitutotumori.mi.it, Pellegrinelli, Alessandro, E-mail: alessandro.pellegrinelli@istitutotumori.mi.it, Marchianò, Alfonso, E-mail: alfonso.marchiano@istitutotumori.mi.it, and Mazzaferro, Vincenzo, E-mail: vincenzo.mazzaferro@istitutotumori.mi.it. Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile. United States: N. p., 2015. Web. doi:10.1007/S00270-014-0907-0.
Spreafico, Carlo, E-mail: carlo.spreafico@istitutotumori.mi.it, Cascella, Tommaso, E-mail: tommaso.cascella@istitutotumori.mi.it, Facciorusso, Antonio, E-mail: antonio.facciorusso@istitutotumori.mi.it, Sposito, Carlo, E-mail: carlo.sposito@istitutotumori.mi.it, Rodolfo, Lanocita, E-mail: rodolfo.lanocita@istitutotumori.mi.it, Morosi, Carlo, E-mail: carlo.morosi@istitutotumori.mi.it, Civelli, Enrico M., E-mail: enrico.civelli@istitutotumori.mi.it, Vaiani, Marta, E-mail: marta.vaiani@istitutotumori.mi.it, Bhoori, Sherrie, E-mail: sherrie.bhoori@istitutotumori.mi.it, Pellegrinelli, Alessandro, E-mail: alessandro.pellegrinelli@istitutotumori.mi.it, Marchianò, Alfonso, E-mail: alfonso.marchiano@istitutotumori.mi.it, & Mazzaferro, Vincenzo, E-mail: vincenzo.mazzaferro@istitutotumori.mi.it. Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile. United States. doi:10.1007/S00270-014-0907-0.
Spreafico, Carlo, E-mail: carlo.spreafico@istitutotumori.mi.it, Cascella, Tommaso, E-mail: tommaso.cascella@istitutotumori.mi.it, Facciorusso, Antonio, E-mail: antonio.facciorusso@istitutotumori.mi.it, Sposito, Carlo, E-mail: carlo.sposito@istitutotumori.mi.it, Rodolfo, Lanocita, E-mail: rodolfo.lanocita@istitutotumori.mi.it, Morosi, Carlo, E-mail: carlo.morosi@istitutotumori.mi.it, Civelli, Enrico M., E-mail: enrico.civelli@istitutotumori.mi.it, Vaiani, Marta, E-mail: marta.vaiani@istitutotumori.mi.it, Bhoori, Sherrie, E-mail: sherrie.bhoori@istitutotumori.mi.it, Pellegrinelli, Alessandro, E-mail: alessandro.pellegrinelli@istitutotumori.mi.it, Marchianò, Alfonso, E-mail: alfonso.marchiano@istitutotumori.mi.it, and Mazzaferro, Vincenzo, E-mail: vincenzo.mazzaferro@istitutotumori.mi.it. Sun . "Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile". United States. doi:10.1007/S00270-014-0907-0.
@article{osti_22470096,
title = {Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile},
author = {Spreafico, Carlo, E-mail: carlo.spreafico@istitutotumori.mi.it and Cascella, Tommaso, E-mail: tommaso.cascella@istitutotumori.mi.it and Facciorusso, Antonio, E-mail: antonio.facciorusso@istitutotumori.mi.it and Sposito, Carlo, E-mail: carlo.sposito@istitutotumori.mi.it and Rodolfo, Lanocita, E-mail: rodolfo.lanocita@istitutotumori.mi.it and Morosi, Carlo, E-mail: carlo.morosi@istitutotumori.mi.it and Civelli, Enrico M., E-mail: enrico.civelli@istitutotumori.mi.it and Vaiani, Marta, E-mail: marta.vaiani@istitutotumori.mi.it and Bhoori, Sherrie, E-mail: sherrie.bhoori@istitutotumori.mi.it and Pellegrinelli, Alessandro, E-mail: alessandro.pellegrinelli@istitutotumori.mi.it and Marchianò, Alfonso, E-mail: alfonso.marchiano@istitutotumori.mi.it and Mazzaferro, Vincenzo, E-mail: vincenzo.mazzaferro@istitutotumori.mi.it},
abstractNote = {PurposeTo evaluate the short-term safety and efficacy of the new generation of 70–150 µm drug-eluting beads (M1 DEB) in patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) as a primary therapy or as a bridge to liver transplantation (LT).MethodsForty-five consecutive patients underwent TACE with M1 DEB loaded with doxorubicin (DEBDOX/M1). Clinical data were recorded at 12, 24, and 48 h, 7 and 30 days after treatment. Response was assessed by computed tomographic scan according to the modified response evaluation criteria in solid tumors criteria, and a second DEBDOX/M1 TACE was scheduled within 6 weeks in case of a noncomplete response.ResultsAll patients had well-compensated cirrhosis (97.7 % Child A, 44.4 % hepatitis C virus, median age 61 years). Twenty patients (44.4 %) had Barcelona Clinic for Liver Cancer class B disease; the median number of nodules and their sum of diameters were 2 (range 1–6) and 43 mm (range 10–190), respectively. The mean number of TACE procedures per patient was 1.4. Objective response rate (complete + partial response) was 77.7 % with a median time to best response of 3 months (95 % confidence interval 2–4). In 13 patients, DEBDOX/M1 TACE served as a bridge/downstaging to LT/surgery. Pathology showed that more than 90 % necrosis was achieved in 10 of 28 nodules. DEBDOX/M1 TACE was well tolerated, and the grade 3/4 adverse event rate was low (1 of 65 procedures).ConclusionDEBDOX/M1 TACE is an effective procedure with a favorable safety profile and promising results in terms of objective response rate, tumor downstaging, and necrosis.},
doi = {10.1007/S00270-014-0907-0},
journal = {Cardiovascular and Interventional Radiology},
number = 1,
volume = 38,
place = {United States},
year = {Sun Feb 15 00:00:00 EST 2015},
month = {Sun Feb 15 00:00:00 EST 2015}
}