Conventional versus doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma |
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Authors: | Sacco Rodolfo Bargellini Irene Bertini Marco Bozzi Elena Romano Antonio Petruzzi Pasquale Tumino Emanuele Ginanni Barbara Federici Graziana Cioni Roberto Metrangolo Salvatore Bertoni Michele Bresci Giampaolo Parisi Giuseppe Altomare Emanuele Capria Alfonso Bartolozzi Carlo |
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Affiliation: | aDepartment of Gastroenterology, Pisa University Hospital, Pisa, Italy;bDepartment of Diagnostic and Interventional Radiology, Pisa University Hospital, Pisa, Italy;cInstitute of Internal Medicine, University of Foggia, Foggia, Italy |
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Abstract: | PurposeTo compare short- and long-term clinical outcomes after conventional transarterial chemoembolization and drug-eluting bead (DEB) transarterial chemoembolization in hepatocellular carcinoma (HCC).Materials and MethodsPatients with unresectable HCC unsuitable for ablative therapies were randomly assigned to undergo conventional or DEB chemoembolization. The primary endpoints of the study were safety, toxicity, and tumor response at 1 month. Secondary endpoints were number of repeated chemoembolization cycles, time to recurrence and local recurrence, time to radiologic progression, and survival.ResultsIn total, 67 patients (mean age, 70 y ± 7.7) were evaluated. Mean follow-up was 816 days ± 361. Two periprocedural major complications occurred (2.9%) that were treated by medical therapy without the need for other interventions. A significant increase in alanine aminotransferase levels 24 hours after treatment was reported, which was significantly greater after conventional chemoembolization (n = 34) than after DEB chemoembolization (n = 33; preprocedure, 60 IU ± 44 vs 74 IU ± 62, respectively; at 24 h, 216 IU ± 201 vs 101 IU ± 89, respectively; P = 0.007). No other differences were observed in liver toxicity between groups. At 1 month, complete and partial tumor response rates were 70.6% and 29.4%, respectively, in the conventional chemoembolization group and 51.5% and 48.5%, respectively, in the DEB chemoembolization group. No differences were observed between groups in time to recurrence and local recurrence, radiologic progression, and survival.ConclusionsConventional chemoembolization and DEB chemoembolization have a limited impact on liver function on short- and long-term follow-up and are associated with favorable clinical outcomes. |
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Keywords: | Abbreviations: ALT, alanine aminotransferase BCLC, Barcelona Clinic Liver Cancer DEB, drug-eluting bead HCC, hepatocellular carcinoma |
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