A Single-Center Retrospective Comparison of Doxorubicin-Loaded HepaSphere Transarterial Chemoembolization with Conventional Transarterial Chemoembolization for Patients with Unresectable Hepatocellular Carcinoma

Küçükay, Fahrettin; Badem, Serife; Karan, Adnan; Özdemir, Mustafa; Ökten, Rıza Sarper; Ozbulbul, Nilgun Isiksalan; Küçükay, Murat Bülent; Unlu, Ipek; Bostancı, Erdal Birol; Akdoğan, Meral

doi:10.1016/j.jvir.2015.07.017

Cited by 20 publications

(12 citation statements)

References 25 publications

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“…Song et al [7] showed that the overall survival rates at 6, 12, and 18 months were 93%, 88%, and 88%, respectively, in the DEB-TACE group, which were better than those in the cTACE group (80%, 67%, and 61%, respectively). These results are similar to those obtained in three other studies [8][9][10]. However, a recent RCT performed by Golfieri et al [11] showed that DEB-TACE and cTACE were equally effective regarding 1-and 2-year survival rates(DEB-TACE vs. cTACE; 86.2%vs.…”

Section: Introductionsupporting

confidence: 89%

Transarterial strategies for the treatment of unresectable hepatocellular carcinoma: A systematic review

Yang

Liang

et al. 2020

PLoS ONE

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Conventional transarterial chemoembolization (cTACE), drug-eluting beads (DEB-TACE) and transarterial radioembolization (TARE) are alternative strategies for unresectable hepatocellular carcinoma (HCC). However, which of these strategies is the best is still controversial. This meta-analysis was performed to evaluate the effects of DEB-TACE, TARE and cTACE in terms of overall survival (OS), tumor response and complications. A literature search was conducted using the EMBASE, PubMed, Google Scholar, and Cochrane databases from inception until July 2019 with no language restrictions. The primary outcome was overall survival, and the secondary outcomes included complete response and local recurrence. The comparison of DEB-TACE with cTACE indicated that DEB-TACE has a better OS at 1 year (RR 0.79, 95% CI 0.67-0.93, p = 0.006), 2 years (RR 0.89; 95% CI 0.81-0.99, p = 0.046), and 3 years (RR 0.89; 95% CI 0.81-0.99, p = 0.035). The comparison of TARE with cTACE indicated that TARE has a better OS than cTACE at 2 years (RR 0.87; 95% CI 0.80-0.95, p = 0.003) and 3 years (RR 0.90; 95% CI 0.85-0.96, p = 0.001). The comparison of DEB-TACE with TARE indicated that DEB-TACE has a better OS than TARE at 2 years (RR 0.40; 95% CI 0.19-0.84, p = 0.016). The current meta-analysis suggests that DEB-TACE is superior to both TARE and cTACE in terms of OS. TARE has significantly lower complications than both DEB-TACE and cTACE for patients with HCC. Further multicenter, well-designed randomized controlled trials are needed, especially for evaluating DEB-TACE versus TARE.

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Section: Introductionsupporting

confidence: 89%

Transarterial strategies for the treatment of unresectable hepatocellular carcinoma: A systematic review

Yang

Liang

et al. 2020

PLoS ONE

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“…Since DEB-TACE first became commercially available in 2006, many clinical trials have shown its efficacy in patients with HCC and its ability to overcome the drawbacks of c-TACE (Table 6) (263359606162636465666768). DEB-TACE has, therefore, been used in some institutions as a first-line treatment in addition to c-TACE for the treatment of HCC in patients who are ineligible for curative treatment.…”

Section: C-tace Versus Deb-tacementioning

confidence: 99%

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

et al. 2019

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Conventional transcatheter arterial chemoembolization (c-TACE) is a widely used first-line palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). Despite the effectiveness of c-TACE, to date, technique and procedure scheduling has not yet been standardized. Drug-eluting microspheres (DEMs) were therefore introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization. These DEMs can load various drugs and release them in a sustained manner over a prolonged period. This approach ensures the delivery of high concentrations of chemotherapeutic agents to tumors, without increasing systemic concentrations, and promote tumor ischemia and necrosis. This review summarizes the recent advances in the use of DEM-TACE to treat HCC.

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“…However, the therapeutic outcome of TACE varies greatly from patient to patient because the biological behavior of tumor cells is highly heterogeneous [8]. Recent studies have evidenced that the heterogeneity of TACE response also results in a high incidence of local tumor recurrence, which could reach to 46%, 58%, and 63% at 2, 3, and 5 years of posttreatment, respectively [9][10][11]. Previous studies have confirmed that Cezanne and cytokine signaling 3 methylation are highly related to the heterogeneity of TACE response [8,12].…”

Section: Introductionmentioning

confidence: 99%

Prediction of tumor response via a pretreatment MRI radiomics-based nomogram in HCC treated with TACE

et al. 2021

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Objectives To develop and validate a pre-transcatheter arterial chemoembolization (TACE) MRI-based radiomics model for predicting tumor response in intermediate-advanced hepatocellular carcinoma (HCC) patients. Materials Ninety-nine intermediate-advanced HCC patients (69 for training, 30 for validation) treated with TACE were enrolled. MRI examinations were performed before TACE, and the efficacy was evaluated according to the mRECIST criterion 3 months after TACE. A total of 396 radiomics features were extracted from T2-weighted pre-TACE images, and least absolute shrinkage and selection operator (LASSO) regression was applied to feature selection and model construction. The performance of the model was evaluated by receiver operating characteristic (ROC) curves, calibration curves, and decision curves. Results The AFP value, Child-Pugh score, and BCLC stage showed a significant difference between the TACE response (TR) and non-TACE response (nTR) patients. Six radiomics features were selected by LASSO and the radiomics score (Rad-score) was calculated as the sum of each feature multiplied by the non-zero coefficient from LASSO. The AUCs of the ROC curve based on Rad-score were 0.812 and 0.866 in the training and validation cohorts, respectively. To improve the diagnostic efficiency, the Rad-score was further integrated with the above clinical indicators to form a novel predictive nomogram. Results suggested that the AUC increased to 0.861 and 0.884 in the training and validation cohorts, respectively. Decision curve analysis showed that the radiomics nomogram was clinically useful. Conclusion The radiomics and clinical indicator-based predictive nomogram can well predict TR in intermediate-advanced HCC and can further be applied for auxiliary diagnosis of clinical prognosis. Key Points • The therapeutic outcome of TACE varies greatly even for patients with the same clinicopathologic features. • Radiomics showed excellent performance in predicting the TACE response. • Decision curves demonstrated that the novel predictive model based on the radiomics signature and clinical indicators has great clinical utility.

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A Single-Center Retrospective Comparison of Doxorubicin-Loaded HepaSphere Transarterial Chemoembolization with Conventional Transarterial Chemoembolization for Patients with Unresectable Hepatocellular Carcinoma

Cited by 20 publications

References 25 publications

Transarterial strategies for the treatment of unresectable hepatocellular carcinoma: A systematic review

Transarterial strategies for the treatment of unresectable hepatocellular carcinoma: A systematic review

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

Prediction of tumor response via a pretreatment MRI radiomics-based nomogram in HCC treated with TACE

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