Comparison of the Efficacy of Two Microsphere Embolic Agents for Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma Patients
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Purpose Transarterial chemoembolization (TACE) delivers cytotoxic drugs intra-arterially and induces ischemic necrosis by arterial embolization. Embolization is achieved using a variety of agents that differ widely in particle size and range, deformation, and in vivo arterial distribution. The clinical significance of these differences has not been thoroughly characterized. The present study is to compare the efficacy of Embosphere and Embozene microspheres in TACE therapy for hepatocellular carcinoma. Materials and Methods This retrospective study includes 108 hepatocellular carcinoma (HCC) patients who received TACE/doxorubicin with Embozene (70 patients) or Embosphere (38 patients) at a single medical center. Patient outcomes, including liver function, tumor size, tumor response, and complications after treatment, were analyzed. The change in total target lesion size and tumor response was evaluated according to embolization agent and clinical characteristics. Results The postoperative glutamate oxaloacetate transaminase (mean, 194.5 vs. 147.5; p=0.032) and bilirubin (mean, 1.11 mg/dL vs. 0.73 mg/dL; p=0.016) were higher among patients treated with Embozene, the decrease in the number (55.86±25.55% vs. 41.81±38.51%, p=0.027) and size (56.37±25.91 mm vs. 43.44±37.89 mm, p=0.001) of liver tumors relative to baseline was greater in these patients than in those treated with Embosphere. These greater antitumor effects were achieved using lower doses of doxorubicin than for treatment with Embozene. Minor complications were more common among patients treated with Embosphere than with Embozene. Conclusion These results suggest that Embozene is more efficacious than Embosphere for HCC treatment using TACE/doxorubicin.
Abstract
Purpose Transarterial chemoembolization (TACE) delivers cytotoxic drugs intra-arterially and induces ischemic necrosis by arterial embolization. Embolization is achieved using a variety of agents that differ widely in particle size and range, deformation, and in vivo arterial distribution. The clinical significance of these differences has not been thoroughly characterized. The present study is to compare the efficacy of Embosphere and Embozene microspheres in TACE therapy for hepatocellular carcinoma. Materials and Methods This retrospective study includes 108 hepatocellular carcinoma (HCC) patients who received TACE/doxorubicin with Embozene (70 patients) or Embosphere (38 patients) at a single medical center. Patient outcomes, including liver function, tumor size, tumor response, and complications after treatment, were analyzed. The change in total target lesion size and tumor response was evaluated according to embolization agent and clinical characteristics. Results The postoperative glutamate oxaloacetate transaminase (mean, 194.5 vs. 147.5; p=0.032) and bilirubin (mean, 1.11 mg/dL vs. 0.73 mg/dL; p=0.016) were higher among patients treated with Embozene, the decrease in the number (55.86±25.55% vs. 41.81±38.51%, p=0.027) and size (56.37±25.91 mm vs. 43.44±37.89 mm, p=0.001) of liver tumors relative to baseline was greater in these patients than in those treated with Embosphere. These greater antitumor effects were achieved using lower doses of doxorubicin than for treatment with Embozene. Minor complications were more common among patients treated with Embosphere than with Embozene. Conclusion These results suggest that Embozene is more efficacious than Embosphere for HCC treatment using TACE/doxorubicin.
참고문헌 (12)
- Balogh J, "Hepatocellular carcinoma : a review", J Hepatocell Carcinoma, 3, pp.41~53 (2016)
- Wang YX, "Transcatheter embolization therapy in liver cancer : an update of clinical evidences", Chin J Cancer Res, 27, pp.96~121 (2015)
- Lencioni R, "Chemoembolization of hepatocellular carcinoma", Semin Intervent Radiol, 30, pp.3~11 (2013)
- Bruix J, "American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma", Hepatology, 42, pp.1208~1236 (2005)
- Llovet JM, "Design and endpoints of clinical trials in hepatocellular carcinoma", J Natl Cancer Inst, 100, pp.698~711 (2008)
- Marelli L, "Transarterial therapy for hepatocellular carcinoma:which technique is more effective? A systematic review of cohort and randomized studies", Cardiovasc Intervent Radiol, 30, pp.6~25 (2007)
- Lewis AL, "Comparative in vitro evaluation of microspherical embolisation agents", J Mater Sci Mater Med, 17, pp.1193~1204 (2006)
- Vaidya S, "An overview of embolic agents", Semin Intervent Radiol, 25, pp.204~215 (2008)
- Verret V, "The arterial distribution of Embozene and Embosphere microspheres in sheep kidney and uterus embolization models", J Vasc Interv Radiol, 22, pp.220~228 (2011)
- Bonomo G, "Bland embolization in patients with unresectable hepatocellular carcinoma using precise, tightly sizecalibrated, anti-inflammatory microparticles : first clinical experience and one-year follow-up", Cardiovasc Intervent Radiol, 33, pp.552~559 (2010)
- Facciorusso A, "Transarterial chemoembolization : Evidences from the literature and applications in hepatocellular carcinoma patients", World J Hepatol, 7, pp.2009~2019 (2015)
- Vahid B, "Pulmonary complications of novel antineoplastic agents for solid tumors", Chest, 133, pp.528~538 (2008)