Aim: Doxorubicin-eluting beads transarterial chemoembolization (DEB-TACE) is reported to improve survival and tolerability when compared with conventional lipiodol-TACE (cTACE) for the treatment of hepatocellular carcinoma (HCC). The aim of this study was to evaluate tolerability and long-term survival in patients treated with cTACE or DEB-TACE in a real-life setting. Methods: Incidence of adverse events and overall survival in HCC patients treated with either cTACE or DEB-TACE at Karolinska University Hospital 2004-2012 were analyzed retrospectively. Median follow-up was 7.1 years. Patients were censored when transplanted or at the end of follow-up. Patients receiving both cTACE and DEB-TACE, or treated with resection or ablation post-TACE were excluded from the survival analysis. Results: A total of 202 patients (76 cTACE and 126 DEB-TACE) were eligible for analysis of adverse events, and 179 patients (69 cTACE and 110 DEB-TACE) were included in the survival analysis. cTACE patients were younger and had fewer tumors but higher BCLC stage than DEB-TACE. Child-Pugh and ECOG performance status were similar between groups. Adverse events (abdominal pain, nausea and vomiting, fever, fatigue) were significantly less common in the DEB-TACE group. Median survival was 17.1 months in the cTACE group and 19.1 months in the DEB-TACE (NS). In multivariate Cox regression analysis, portal vein thrombosis and tumor size were associated with increased, and sorafenib treatment post-TACE with decreased mortality. Conclusion: In this retrospective real-life analysis, DEB-TACE had better tolerability compared to cTACE, but overall survival did not differ between the two treatments. Portal vein thrombosis, tumor size and sorafenib treatment after TACE influence survival.

No abstract

Background Both dual time-point 99m Tc-hexamethylpropylene amine oxime (HMPAO)-leukocyte scintigraphy and dual-tracer 99m Tc-HMPAO-leukocyte scintigraphy (with the addition of 99m Tc-nanocolloid bone marrow scintigraphy) have been used to diagnose prosthetic joint infection (PJI). A treatment evaluation of persistent PJI using these imaging protocols has yet to be presented. Objective The purpose of this study was to compare the accuracy of dual time-point 99m Tc-HMPAO-leukocyte scintigraphy to the dual-tracer alternative of single time-point 99m Tc-HMPAO-leukocyte scintigraphy or single-photon emission computed tomography/computed tomography (SPECT/CT) combined with a 99m Tc-nanocolloid bone marrow scintigraphy or SPECT/CT, for treatment evaluation of PJI. Material and methods Thirty-one PJI patients under antibiotic treatment were included in this retrospective study. Examinations were organized into three settings. Setting one used dual time-point approach with delayed (2 h) and late (24 h) planar 99m Tc-HMPAO-leukocyte scintigraphy, including both visual and semiquantitative analysis. Setting two used delayed (2 h) planar 99m Tc-HMPAO-leukocyte scintigraphy combined with 99m Tc-nanocolloid bone marrow scintigraphy and for setting three SPECT/CT replaced planar imaging. Results Accuracy was 0.68 for visual evaluation and 0.55 for semiquantitative evaluation of setting one; 0.71 for setting two; and 0.68 for setting three. Sensitivity was 0.54 for visual evaluation and 0.31 for semiquantitative evaluation of setting one; 0.38 for setting two; and 0.46 for setting three. Specificity was 0.78 for visual evaluation and 0.72 for semiquantitative evaluation of setting one; 0.94 for setting two; and 0.83 for setting three. Conclusion No significant difference in accuracy, sensitivity, or specificity between the approaches for treatment evaluation of suspected persistent PJI in the hip or knee was observed.