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Safety Profile of Sequential Transcatheter Chemoembolization with DC Bead™: Results of 237 Hepatocellular Carcinoma (HCC) Patients

  • Clinical Investigation
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Abstract

Introduction

Complications of chemoembolization performed with DC Bead™ loaded with doxorubicin (DEBDOX) of diameters 100–300 μm and 300–500 μm are presented in this paper. These diameters are currently the smallest available in drug-eluting technology.

Methods

Included are 237 patients who were treated with sequential DEBDOX with doxorubicin loaded at 37.5 mg/ml of DC Bead. The National Cancer Institute Common Terminology Criteria for Adverse Events (version 3.0) were used to categorize complications.

Results

Thirty-day mortality was 1.26% (3/237). Incidence of grade 5 complications was 1.26% (3/237). Overall, grade 4 complications resulted in 5.48% (13/237) (irreversible liver failure, cholecystitis). Grade 2 liver function deterioration developed in 10 patients (4.2%). Cholecystitis/grade 2 and 4 incidents were observed in 3.6–5.06% across sessions (overall 13 patients; 5.48%). Postembolization Syndrome (PES) grade 1 or 2 was observed in up to 86.5%; however, grade 2 was observed in 25–42.19% across treatments. Pleural effusion was seen in eight patients (overall 3.37%; grade 1 in 1.8–3.7% across treatments; grade 3 in 0.42%). Grade 1 procedure-related laboratory pancreatitis was seen in 0.45%, and grade 2 gastrointestinal bleeding was seen in 0.84%. Procedure-associated skin erythema/grade 1 was seen in 0.84%. There was no correlation of liver failure or transient liver function deterioration with the diameter of the beads (p = 0.25–0.37 and p = 0.14–0.89, respectively). Stratifying with the diameter of the beads correlation values was: for cholecystitis (p = 0.11–0.96 across treatments), PES (p = 0.35–0.83), temporary/grade 1 elevation of liver enzymes (p = 0.002–0.0001), and bilirubin (p = 0.04–0.99).

Conclusions

DEBDOX chemoembolization is safe and small calibres do not result in increased complication rates compared with results of series using larger diameters of beads.

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The authors claim no conflict of interest.

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Authors and Affiliations

  1. Imaging and Research Unit, Evgenidion University Hospital, 20 Papadiamandopoulou Street, Ilisia, 11528, Athens, Greece

    Katerina Malagari, Mary Pomoni, Themistoklis N. Spyridopoulos, Alexis Kelekis, Michalis Angelopoulos, Savvas Tandeles & Dimitrios Kelekis

  2. 2nd Department of Radiology, Attikon University Hospital, Rimini 1 Haidari, Athens, Greece

    Katerina Malagari, Themistoklis N. Spyridopoulos, Alexis Kelekis & Efthymia Alexopoulou

  3. Department of Radiology, Tzanion Hospital, Athens, Greece

    Hippokratis Moschouris & John Kornezos

  4. Department of Internal Medicine, University of Athens, Athens, Greece

    Spyros Dourakis & John Koskinas

  5. Lauzane, Switzerland

    Anastasia Pomoni

  6. Department of Surgery, Tzanion Hospital, Athens, Greece

    Athanasios Marinis & Spyros Rizos

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  1. Katerina Malagari
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  2. Mary Pomoni
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Correspondence to Katerina Malagari.

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Malagari, K., Pomoni, M., Spyridopoulos, T.N. et al. Safety Profile of Sequential Transcatheter Chemoembolization with DC Bead™: Results of 237 Hepatocellular Carcinoma (HCC) Patients. Cardiovasc Intervent Radiol 34, 774–785 (2011). https://doi.org/10.1007/s00270-010-0044-3

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  • DOI: https://doi.org/10.1007/s00270-010-0044-3

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