• J Vasc Interv Radiol · Nov 2017

    Transarterial Chemoembolization with Small Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: Experience from a Cohort of 421 Patients at an Italian Center.

    • Camillo Aliberti, Riccardo Carandina, Sara Lonardi, Vincenzo Dadduzio, Alessandro Vitale, Enrico Gringeri, Giacomo Zanus, and Umberto Cillo.
    • Oncology Radiodiagnostics, Oncology Institute of Veneto (IOV), Institute for the Research and Treatment of Cancer (IRCCS), Via Gattamelata 64, 35128 Padua, Italy. Electronic address: camy.ali@libero.it.
    • J Vasc Interv Radiol. 2017 Nov 1; 28 (11): 1495-1502.

    PurposeTo assess the safety, tolerability, and efficacy of small drug-eluting embolic (DEE) agents (70-150 μm) for chemoembolization of hepatocellular carcinoma (HCC).Materials And MethodsThis single-center, single-arm, retrospective study involved 421 patients (mean age, 66.1 y ± 9.8 [standard deviation]) with Barcelona Clinic Liver Cancer (BCLC) stage A (n = 88), B (n = 140), or C (n = 193) HCC and Child-Pugh class A (n = 233) or B (n = 188) cirrhosis. Patients had a mean of 7.2 lesions ± 4.8 (range, 1-21; mean diameter of target lesion, 21.4 cm ± 8.1; unilobar, n = 132; bilobar, n = 289; portal vein involvement, n = 193). One (n = 320) or 2 (n = 101) vials of small DEEs loaded with doxorubicin 50 mg per vial were delivered selectively (ie, segmentally) or superselectively (ie, directly into the tumor-feeding vessel) until complete delivery or stasis/near-stasis. Treatment was repeated in patients with partial response or stable disease at 1- or 3-month follow-up (mean, 2.0 cycles ± 0.9). Adverse events within 30 days of chemoembolization, response per modified Response Evaluation Criteria In Solid Tumors (mRECIST), and survival were assessed.ResultsWithin 30 days after treatment, no deaths or bleeding events occurred, but all patients had at least 1 episode of postembolization syndrome (pain, fever, and/or nausea/vomiting; 27.1% grade 3/4 per National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0) and increased bilirubin and liver aminotransferase levels (0.2% and 5.9% grade 3/4, respectively). Overall response rates were 94.5% at 3 months and 99.5% at 6 months. Median overall survival was 42.0 months (95% confidence interval, 38.0-43.0 mo).ConclusionsChemoembolization with small DEE agents is well tolerated and an effective treatment for a broad range of patients with liver-confined HCC.Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

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