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Efficacy of preoperative transcatheter arterial chemoembolization combined with systemic chemotherapy for treatment of unresectable hepatoblastoma in children

Japanese Journal of Radiology volume 32, pages 529–536 (2014)Cite this article

Abstract

Purpose

The purpose of this study was to evaluate, retrospectively, the clinical efficacy of preoperative transcatheter arterial chemoembolization (TACE) combined with systemic chemotherapy for unresectable hepatoblastoma.

Materials and methods

Five boys and three girls (mean age 15.2 months) were treated with preoperative TACE combined with systemic chemotherapy for unresectable hepatoblastomas. Mean tumor diameter and mean alfa-fetoprotein (AFP) level were 11.8 cm and 549,386 ng/mL, respectively. Pretreatment, the extent of disease (PRETEXT) was: II, 1; III, 6; IV, 1. For all patients, preoperative systemic chemotherapy was administered before TACE. At each TACE, carboplatin and adriamycin mixed with iodized oil were infused into the feeding arteries. Tumor response and prognosis after treatment were evaluated.

Results

TACE resulted in few Grade 1 adverse effects (AEs), without G3 or more AEs, according to CTACAE 3.0. Mean tumor shrinkage was 60.9 %, and the mean AFP decrease from initial levels was 94.8 %. In all cases TACE combined with systemic chemotherapy enabled subsequent safe and complete surgical resection. After a mean follow-up of 59 months, tumor-free survival was 75 %.

Conclusion

Preoperative TACE combined with systemic chemotherapy was effective in inducing surgical resectability of unresectable hepatoblastoma.

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Conflict of interest

We have no direct or indirect financial interest in the products under investigation or the subject matter discussed in this manuscript.

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Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masakazu Hirakawa, Akihiro Nishie, Yoshiki Asayama, Nobuhiro Fujita, Kousei Ishigami & Hiroshi Honda

  2. Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 1-5 Hangi-cho, Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan

    Tatsurou Tajiri

  3. Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Tomoaki Taguchi

Authors
  1. Masakazu Hirakawa
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  2. Akihiro Nishie
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  3. Yoshiki Asayama
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  4. Nobuhiro Fujita
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  5. Kousei Ishigami
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  6. Tatsurou Tajiri
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  7. Tomoaki Taguchi
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  8. Hiroshi Honda
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Corresponding author

Correspondence to Masakazu Hirakawa.

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Hirakawa, M., Nishie, A., Asayama, Y. et al. Efficacy of preoperative transcatheter arterial chemoembolization combined with systemic chemotherapy for treatment of unresectable hepatoblastoma in children. Jpn J Radiol 32, 529–536 (2014). https://doi.org/10.1007/s11604-014-0340-y

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  • DOI: https://doi.org/10.1007/s11604-014-0340-y

Keywords

  • Hepatoblastoma
  • TACE
  • Systemic chemotherapy