CardioVascular and Interventional Radiology

, Volume 35, Issue 5, pp 1119–1128 | Cite as

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

  • Katerina Malagari
  • Mary Pomoni
  • Hippocrates Moschouris
  • Evanthia Bouma
  • John Koskinas
  • Aspasia Stefaniotou
  • Athanasios Marinis
  • Alexios Kelekis
  • Efthymia Alexopoulou
  • Achilles Chatziioannou
  • Katerina Chatzimichael
  • Spyridon Dourakis
  • Nikolaos Kelekis
  • Spyros Rizos
  • Dimitrios Kelekis
Clinical Investigation

Abstract

Purpose

The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand.

Materials and Methods

173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %).

Results

Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival.

Conclusion

DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

Keywords

Hepatocellular carcinoma Transarterial chemoembolization Drug-eluting beads Survival Doxorubicin loaded drug eluting beads Embolization in unresectable hepatocellular carcinoma 

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Katerina Malagari
    • 1
  • Mary Pomoni
    • 2
  • Hippocrates Moschouris
    • 3
  • Evanthia Bouma
    • 2
  • John Koskinas
    • 6
  • Aspasia Stefaniotou
    • 2
  • Athanasios Marinis
    • 4
  • Alexios Kelekis
    • 1
  • Efthymia Alexopoulou
    • 1
  • Achilles Chatziioannou
    • 5
  • Katerina Chatzimichael
    • 1
  • Spyridon Dourakis
    • 6
  • Nikolaos Kelekis
    • 1
  • Spyros Rizos
    • 4
  • Dimitrios Kelekis
    • 2
  1. 1.Second Department of RadiologyUniversity of AthensAthensGreece
  2. 2.Imaging and Research UnitUniversity of AthensAthensGreece
  3. 3.Department of RadiologyTzanion HospitalPireusGreece
  4. 4.Department of SurgeryTzanion HospitalPireusGreece
  5. 5.First Department of RadiologyUniversity of AthensAthensGreece
  6. 6.Department of Internal Medicine and HepatologyIppokration Hospital, University of AthensAthensGreece

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