Drug-eluting Bead-Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma Refractory to Conventional Lipiodol-based Transcatheter Arterial Chemoembolization

Abstract

Saito Kobayashi, Kazuto Tajiri, Aiko Murayama, Toshiki Entani, Yuka Futsukaichi, Kohei Nagata, Kosuke Takahashi, Ichiro Yasuda Department of Gastroenterology, Toyama University Hospital, Toyama, JapanCorrespondence: Kazuto TajiriDepartment of Gastroenterology, Toyama University Hospital, 2630 Sugitani, Toyama 930-0194, JapanTel [phone]Fax [phone]Email [email protected]: To evaluate the potential of drug-eluting bead (DEB)-transcatheter arterial chemoembolization (TACE) as a treatment option for patients with refractory to conventional lipiodol-based TACE (c-TACE) especially with decreased liver function.Patients and Methods: We retrospectively evaluated the treatment results of DEB-TACE for 89 HCC nodules in 27 patients with c-TACE refractory according to liver function.Results: Although overall survival was significantly better in Child–Pugh A patients than in Child–Pugh B patients (median survival time, MST: 561 vs 347 days, p=0.031), progression-free survival was almost similar in both patients between Child–Pugh A and B (MST: 79 vs 87 days, p=0.534). Regarding antitumor response, the objective response rate (ORR) and disease-control rate (DCR) were 5.3/12.5% and 52.7/87.5% in Child–Pugh A/B, respectively. In each 89 HCC nodules, ORR and DCR were almost similar between Child–Pugh A and B (ORR, 20.3 vs 13.3%; DCR, 77.0 vs 73.3%, respectively). Adverse events of DEB-TACE were well-tolerated, and liver function was reserved during DEB-TACE procedures.Conclusion: DEB-TACE could be a therapeutic option for advanced HCC patients with c-TACE refractory and decreased liver function.Keywords: TACE-refractory, drug-eluting bead, post-embolization syndrome, microsphere, tyrosine kinase inhibitor

Keywords

• tace-refractory
• drug-eluting bead
• post-embolization syndrome
• microsphere
• tyrosine kinase inhibitor