Abdominal Imaging

, Volume 33, Issue 5, pp 512–519

Transcatheter chemoembolization in the treatment of HCC in patients not eligible for curative treatments: midterm results of doxorubicin-loaded DC bead

  • Katerina Malagari
  • Efthimia Alexopoulou
  • Katerina Chatzimichail
  • Brenda Hall
  • John Koskinas
  • Samantha Ryan
  • Eva Gallardo
  • Alexis Kelekis
  • Athanassios Gouliamos
  • Dimitrios Kelekis
Article

DOI: 10.1007/s00261-007-9334-x

Cite this article as:
Malagari, K., Alexopoulou, E., Chatzimichail, K. et al. Abdom Imaging (2008) 33: 512. doi:10.1007/s00261-007-9334-x

Abstract

Purpose

To examine the results of segmental transcatheter arterial chemoembolization with doxorubicin-loaded DC Bead in the treatment of hepatocellular carcinoma (HCC) in non-surgical candidates.

Material and methods

Seventy-one patients (60% men; 11% women; mean age 63; range 46–71 years) with documented HCC of 3–10 cm in diameter (mean 6.2) were enrolled prospectively in the study. All patients had cirrhosis-related HCC that was developed on an underlying controlled hepatitis infection. Only patients with compensated cirrhosis—Child A or B—were included in this study.

Results

Overall complete response (CR) according to EASL on an intention to treat basis was seen in 11 patients who developed complete necrosis (15.5%). Objective response (OR) ranged from 66.2% to 85.5% across the four treatments. Survival at 12 months was 97.05%. Sustained CR was observed in 11 (16.1%), and OR in 49 (72%). Sustained partial response was seen in 49 patients (72.05%). Survival at 18 months was 94.1%. At 24 months follow-up survival was 91.1%. Sustained OR was seen in 45 patients (66.2%) while sustained CR was 16.1% (11/68). At 30 months survival was 88.2%. One patient with CR developed multifocal HCC in areas that most likely were not embolized during the previous embolization sessions. In this patient recurrence-free survival was 28 months. Alpha Fetroprotein levels decreased significantly in measurements 1 month post each procedure (p < 0.001). Bilirubin, γ-GT, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase (ALP) showed only transient increases observed during the study period. Severe procedure-related complications were seen in 4.2% (cholecystitis: n = 1; liver abscess: n = 1; pleural effusion: n = 1). Post Embolization Syndrome (PES) was observed in all patients.

Conclusion

Transcatheter arterial chemoembolization with DC Bead is an effective and safe procedure in the treatment of HCC patients not eligible for curative treatments with high rates of response and high rates of mid term survival.

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Katerina Malagari
    • 1
  • Efthimia Alexopoulou
    • 1
  • Katerina Chatzimichail
    • 1
  • Brenda Hall
    • 2
  • John Koskinas
    • 3
  • Samantha Ryan
    • 2
  • Eva Gallardo
    • 2
  • Alexis Kelekis
    • 1
  • Athanassios Gouliamos
    • 1
  • Dimitrios Kelekis
    • 1
  1. 1.Department of RadiologyUniversity of AthensAthensGreece
  2. 2.BiocompatiblesSurreyUnited Kingdom
  3. 3.Department of Internal MedicineUniversity of AthensAthensGreece