• J Vasc Interv Radiol · Feb 2014

    Transcatheter arterial chemoembolization with doxorubicin-eluting superabsorbent polymer microspheres in the treatment of hepatocellular carcinoma: midterm follow-up.

    • Jeroen Dekervel, Hannah van Malenstein, Vincent Vandecaveye, Frederik Nevens, Jos van Pelt, Sam Heye, Wim Laleman, Werner Van Steenbergen, Johan Vaninbroukx, Chris Verslype, and Geert Maleux.
    • Department of Hepatology, University Hospitals Leuven, Herestraat 49; Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium.
    • J Vasc Interv Radiol. 2014 Feb 1; 25 (2): 248-55.e1.

    PurposeTo investigate prospectively the safety, tolerability, and efficacy of transarterial chemoembolization using superabsorbent polymer (SAP) microspheres loaded with doxorubicin for the treatment of hepatocellular carcinoma (HCC).Materials And MethodsDuring the years 2006-2011, 64 patients underwent 144 transarterial chemoembolization with SAP microspheres procedures. Most of the patients were staged as Barcelona Clinic Liver Cancer class B (65%). The most frequent underlying liver diseases were hepatitis C (35%) and alcoholic liver disease (28%) resulting in Child-Pugh A (73.4%) or Child-Pugh B (17%) liver cirrhosis. Tumor response was assessed using modified Response Evaluation Criteria in Solid Tumors with magnetic resonance (MR) imaging performed 4-6 weeks after each procedure.ResultsSerious adverse events (n = 9) were ischemic or infectious in nature. Transarterial chemoembolization with SAP microspheres resulted in objective response rates of 67.5%, 44.5%, and 25% after first, second, and third sessions. There were 16 patients (25%) who underwent orthotopic liver transplantation after transarterial chemoembolization with SAP microspheres, of whom 2 experienced recurrent disease. During a median follow-up time of 14 months (range, 2-55 mo), 26 patients (40.5%) died. Median overall and transplant-free survivals were 20.5 months (95% confidence interval, 13.2-27.7) and 18 months (95% confidence interval, 14.2-21.8), respectively.ConclusionsTransarterial chemoembolization with SAP microspheres has an excellent safety profile in cirrhotic patients, even in the presence of advanced liver disease (Child-Pugh B) or advanced stages of HCC. This treatment produced meaningful tumor response rates as assessed by MR imaging.© 2014 Published by SIR on behalf of The Society of Interventional Radiology.

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