DC Bead Transarterial Chemoembolization Is Effective in Hepatocellular Carcinoma Refractory to Conventional Transarteral Chemoembolization: A Pilot Study
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Background/Aims: To determine if hepatocellular carcinoma refractory to conventional transarterial chemoembolization (TACE) responds to TACE with DC beads. Methods: Between July 2008 to June 2010, 435 patients underwent TACE. Of these, 10 patients who had tumors refractory to conventional TACE and who thus were treated with TACE with DC beads were enrolled in this study. The treatment response after TACE with DC beads was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and the Response Evaluation Criteria in Cancer of the Liver (RECICL). Results: Ten tumors were treated in 10 patients. Using the mRECIST and the RECICL, a complete response was observed in four (40%) of the tumors, and six tumors (60%) showed a partial response. Eight (80%) out of 10 HCCs showed delayed enhancement patterns upon angiography, and better responses were observed in these cases following DC bead treatment. The adverse effects of treatment with DC beads became tolerable. Conclusions: TACE with DC beads was effective for HCCs refractory to conventional TACE, and this treatment elicited a better response, especially when the tumors were small and showed a delayed enhancement pattern upon angiography
Abstract
Background/Aims: To determine if hepatocellular carcinoma refractory to conventional transarterial chemoembolization (TACE) responds to TACE with DC beads. Methods: Between July 2008 to June 2010, 435 patients underwent TACE. Of these, 10 patients who had tumors refractory to conventional TACE and who thus were treated with TACE with DC beads were enrolled in this study. The treatment response after TACE with DC beads was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and the Response Evaluation Criteria in Cancer of the Liver (RECICL). Results: Ten tumors were treated in 10 patients. Using the mRECIST and the RECICL, a complete response was observed in four (40%) of the tumors, and six tumors (60%) showed a partial response. Eight (80%) out of 10 HCCs showed delayed enhancement patterns upon angiography, and better responses were observed in these cases following DC bead treatment. The adverse effects of treatment with DC beads became tolerable. Conclusions: TACE with DC beads was effective for HCCs refractory to conventional TACE, and this treatment elicited a better response, especially when the tumors were small and showed a delayed enhancement pattern upon angiography
참고문헌 (31)
- Parkin DM, "Global cancer statistics, 2002", CA Cancer J Clin, 55, pp.74~108 (2005)
- Bruix J, "Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma", Hepatology, 42, pp.1208~1236 (2005)
- Llovet JM, "Novel advancements in the management of hepatocellular carcinoma in 2008", J Hepatol, 48(Suppl 1), pp.S20~S37 (2008)
- Lo CM, "Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma", Hepatology, 35, pp.1164~1171 (2002)
- Llovet JM, "Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival", Hepatology, 37, pp.429~442 (2003)
- Bruix J, "Chemoembolization for hepatocellular carcinoma", Gastroenterology, 127(5 Suppl 1), pp.S179~S188 (2004)
- Llovet JM, "Hepatocellular carcinoma", Lancet, 362, pp.1907~1917 (2003)
- 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)
- Lammer J, "Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study", Cardiovasc Intervent Radiol, 33, pp.41~52 (2010)
- Meza-Junco J, "Locoregional radiological treatment for hepatocellular carcinoma: which, when and how?", Cancer Treat Rev, 38, pp.54~62 (2012)
- Hong K, "New intra-arterial drug delivery system for the treatment of liver cancer: preclinical assessment in a rabbit model of liver cancer", Clin Cancer Res, 12, pp.2563~2567 (2006)
- Nicolini A, "Transarterial chemoembolization with epirubicin-eluting beads versus transarterial embolization before liver transplantation for hepatocellular carcinoma", J Vasc Interv Radiol, 21, pp.327~332 (2010)
- Kudo M, "Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version", Dig Dis, 29, pp.339~364 (2011)
- Lencioni R, "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma", Semin Liver Dis, 30, pp.52~60 (2010)
- Kudo M, "Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan (2009 revised version)", Hepatol Res, 40, pp.686~692 (2010)
- U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, "Common terminology criteria for adverse events (CTCAE)" (2009), National Cancer Institute
- Llovet JM, "Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial", Lancet, 359, pp.1734~1739 (2002)
- Poyanli A, "Palliative treatment of hepatocellular carcinoma by chemoembolization", Acta Radiol, 42, pp.602~607 (2001)
- "Recurrences of hepatocellular carcinoma following initial remission by transcatheter arterial chemoembolization", Journal of Gastroenterology and Hepatology, 17(1), pp.52~58 (2002), Blackwell Publishing Inc.
- Johnson PJ, "Pharmacokinetics and toxicity of intraarterial adriamycin for hepatocellular carcinoma: effect of coadministration of lipiodol", J Hepatol, 13, pp.120~127 (1991)
- Lewis AL, "Pharmacokinetic and safety study of doxorubicin-eluting beads in a porcine model of hepatic arterial embolization", J Vasc Interv Radiol, 17, pp.1335~1343 (2006)
- Namur J, "Embolization of hepatocellular carcinoma with drug-eluting beads: doxorubicin tissue concentration and distribution in patient liver explants", J Hepatol, 55, pp.1332~1338 (2011)
- Kudo M, "Multistep human hepatocarcinogenesis: correlation of imaging with pathology", J Gastroenterol, (44 Suppl 19), pp.112~118 (2009)
- Krinsky G, "Imaging of dysplastic nodules and small hepatocellular carcinomas: experience with explanted livers", Intervirology, 47, pp.191~198 (2004)
- Murakami T, "Multidetector row CT and MR imaging in diagnosing hepatocellular carcinoma", Intervirology, 47 (2004)
- Kudo M, "Atypical large well-differentiated hepatocellular carcinoma with benign nature: a new clinical entity", Intervirology, 47, pp.227~237 (2004)
- Ebied OM, "Evaluation of responses to chemoembolization in patients with unresectable hepatocellular carcinoma", Cancer, 97, pp.1042~1050 (2003)
- Herber SC, "Transarterial chemoembolization in patients not eligible for liver transplantation: single-center results", AJR Am J Roentgenol, 190, pp.1035~1042 (2008)
- Chan AO, "A prospective study regarding the complications of transcatheter intraarterial lipiodol chemoembolization in patients with hepatocellular carcinoma", Cancer, 94, pp.1747~1752 (2002)
- Sacco R, "Conventional versus doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma", J Vasc Interv Radiol, 22, pp.1545~1552 (2011)
- Malagari K, "Transcatheter chemoembolization in the treatment of HCC in patients not eligible for curative treatments: midterm results of doxorubicin-loaded DC bead", Abdom Imaging, 33, pp.512~519 (2008)