Journal of Hepatocellular Carcinoma (Jan 2023)

Efficacy and Safety of Combined Ethanol-Lipiodol Mixture and Drug-Eluting Bead TACE for Large HCC

  • Chuang YH,
  • Cheng YF,
  • Tsang LLC,
  • Ou HY,
  • Hsu HW,
  • Lim WX,
  • Huang PH,
  • Weng CC,
  • Yu CY

Journal volume & issue
Vol. Volume 10
pp. 81 – 90

Abstract

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Yi-Hsuan Chuang,* Yu-Fan Cheng,* Leo Leung-Chit Tsang, Hsin-You Ou, Hsien-Wen Hsu, Wei-Xiong Lim, Po-Hsun Huang, Ching-Chun Weng, Chun-Yen Yu Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, 833401, Taiwan*These authors contributed equally to this workCorrespondence: Chun-Yen Yu, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung, 833401, Taiwan, Tel +886-7-731-7123 #3027, Email [email protected]: To evaluate treatment response, survival and safety of a novel TACE using combination of ethanol-Lipiodol mixture and drug-eluting beads in patients with large unresectable HCC, single tumor > 8 cm or multiple tumors with the largest tumor diameter > 5 cm and total tumor diameter > 10 cm.Patients and Methods: Between June 2016 and February 2020, a total of 27 patients were enrolled in this retrospective cohort study. Treatment response was assessed at first month after the treatment; progression-free survival (PFS) and overall survival (OS) were evaluated. The prognostic factors associated with patient survival were statistically analyzed by the Cox regression model. Adverse events were recorded.Results: The maximum diameter of the tumors ranged from 5 cm to 17 cm (mean 10.48 cm). The objective response and disease control rates were 56% and 78%, respectively, at 1-month follow-up. The median survival time was 15.9 months (95% CI, 9.03– 34.76 months). The OS rates were 76.9% at six months, 65.2% at one year and 44.8% at two years. AFP > 400 ng/mL (p = 0.0306), maximum tumor size > 10cm (p = 0.0240) were potential risk factors for OS. Regarding safety, major complications occurred in one patient (1/27, 3.7%), presenting with transient hepatic encephalopathy.Conclusion: Combined DEB-TACE appeared to have favorable objective tumor response. It can be an effective treatment option for large unresectable HCC.Keywords: hepatocellular carcinoma, transarterial chemoembolization, treatment response, prognosis

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