Safety and Effectiveness of Chemoembolization with Drug-Eluting Beads for Advanced-Stage Hepatocellular Carcinoma
- 1.2k Downloads
According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC.
In this institutional review board-approved, retrospective study, 80 patients with advanced-stage HCC underwent DEB-TACE with doxorubicin. Patients were evaluated for median hospital stay, incidence of Grade 3/4 toxicities, 30-day mortality, progression-free survival (PFS), and overall survival (OS) following DEB-TACE. Univariate and multivariate analysis were performed for predictors of better OS.
The median hospital stay following DEB-TACE was 1 day (range: 1–11). The median PFS and OS were 5.1 months [95 % confidence interval (CI): 4.1–7.7] and 13.3 months (95 % CI: 10.1–18.6) respectively. On multivariate analysis ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS. Patients with ECOG PS ≤ 1 demonstrated a median survival of 17.7 months compared with 5.6 months for patients with ECOG PS > 1 (p = 0.025). Multiple DEB-TACE procedures (>2 procedures) were associated with improved survival (26.8 months) compared with patients with one or two procedures (11.4 months, p = 0.01). Portal vein thrombosis or extrahepatic disease had no statistically significant association with OS.
DEB-TACE is safe and effective in patients with advanced HCC. ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS.
KeywordsInterventional oncology Chemoembolization/chemoembolisation Liver/hepatic Cancer Hepatocellular carcinoma DEB-TACE
Conflict of interest
Sanjeeva Kalva, Melina Pectasides, Raymond Liu, Niranjan Rachamreddy, Shravani Surakanti, Kalpana Yeddula, Suvranu Ganguli, Stephan Wicky, Lawrence S. Blaszkowsky, Andrew X. Zhu have no conflict of interest.
- 21.Watanabe S, Nishioka M, Ohta Y, Ogawa N, Ito S, Yamamoto Y (1994) Prospective and randomized controlled study of chemoembolization therapy in patients with advanced hepatocellular carcinoma. Cooperative Study Group for Liver Cancer Treatment in Shikoku area. Cancer Chemother Pharmacol 33(Suppl):S93–S96PubMedCrossRefGoogle Scholar
- 24.Common terminology criteria for adverse events v3.0 (CTCAE). http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm. Accessed 7 Apr 2012
- 26.Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRefGoogle Scholar