Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

Maruyama, Mitsunari; Yoshizako, Takeshi; Nakamura, Tomonori; Nakamura, Megumi; Yoshida, Rika; Kitagaki, Hajime

doi:10.1007/s00270-015-1237-6

Cited by 29 publications

(37 citation statements)

References 16 publications

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“…A stronger embolic effect and higher dose of injected chemotherapeutic drugs might induce severe AEs or complications. In fact, Maruyama et al [22] also reported that the incidence of severe biliary injury was higher with B-TACE than with c-TACE. However, there were no significant differences in the incidence of other AEs after TACE.…”

Section: Discussionmentioning

confidence: 99%

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Epirubicin is More Effective than Miriplatin in Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

et al. 2018

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Background: Transcatheter arterial chemoembolization (TACE) is a standard therapy used in the treatment of intermediate hepatocellular carcinoma (HCC). Recently, balloon-occluded TACE (B-TACE) has been developed. Purpose: This study aimed to clarify the effects of B-TACE in patients with HCC, with a focus on which drug is suitable to suspend in Lipiodol for B-TACE. Methods: We retrospectively evaluated 35 patients with HCC treated with B-TACE. Factors associated with enhanced time to progression (TTP) after B-TACE were evaluated using univariate and multivariate analyses. Results: A total of 35 patients with HCC (40 nodules) were treated with B-TACE between June 2013 and August 2016. Epirubicin was used in 25 nodules and miriplatin was used in 15 nodules. Epirubicin (15.1 months) was significantly better than miriplatin (3.2 months) in prolonging the local TTP after B-TACE (p = 0.0293). Epirubicin showed a positive tendency in TE4 (100% tumor necrosis) rate when compared with miriplatin (p = 0.058). Achievement of TE4 was the only significant factor associated with better TTP after B-TACE. Epirubicin- and TACE-naïve statuses were significant factors in achieving TE4 with B-TACE. Conclusion: To enhance the TTP with B-TACE, TE4 should be achieved. Epirubicin is a more optimal anticancer drug (as a Lipiodol suspension) than miriplatin for achieving TE4 with B-TACE.

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Section: Discussionmentioning

confidence: 99%

“…Maruyama et al [22] reported that the amount of injected Lipiodol was higher in B-TACE than in c-TACE. Several studies have reported that the RR of B-TACE was significantly higher than that of c-TACE [12,15].…”

Section: Discussionmentioning

confidence: 99%

Epirubicin is More Effective than Miriplatin in Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

et al. 2018

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“…This occlusion is very interesting because extrahepatic deposition of lipiodol emulsion and embolic agents can be avoided, and tumor‐targeting can theoretically be achieved. Indeed, recent studies have reported on the better outcome of B‐TACE relative to C‐TACE . In this regard, we would like to add that this comparison should take into account the occlusion level and the treatment selectivity, which means to place the catheter precisely in the afferent (feeding) artery of the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Vessel occlusion therefore enhances the therapeutic effect due to the more intense retention of the drug within the tumor . Recently, it was reported that B‐TACE using miriplatin is effective and safe, notwithstanding the fact that Maruyama et al, who compared B‐TACE with C‐TACE, observed liver abscess and infarction when B‐TACE was performed in patients with bile duct dilatation. Intrahepatic abscess can take place in B‐TACE and DEB‐TACE when small biliary terminal vessels are overembolized; these terminal vessels cannot supply their dependent territories when blood and biliary necrosis occurs.…”

Section: Introductionmentioning

confidence: 99%

“…Intrahepatic abscess can take place in B‐TACE and DEB‐TACE when small biliary terminal vessels are overembolized; these terminal vessels cannot supply their dependent territories when blood and biliary necrosis occurs. In addition to Maruyama et al's study, an increasing number of studies are comparing B‐TACE and C‐TACE, pointing out that B‐TACE gives better outcomes …”

Section: Introductionmentioning

confidence: 99%

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Numerical zero‐dimensional hepatic artery hemodynamics model for balloon‐occluded transarterial chemoembolization

Aramburu

Antón

Rivas

et al. 2018

Numer Methods Biomed Eng

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Balloon-occluded transarterial chemoembolization (B-TACE) is a valuable treatment option for patients with inoperable malignant tumors in the liver. Balloon-occluded transarterial chemoembolization consists of the transcatheter infusion of an anticancer drug mixture and embolic agents. Contrary to conventional TACE, B-TACE is performed via an artery-occluding microballoon catheter, which makes the blood flow to redistribute due to the intra- and extrahepatic arterial collateral circulation. Several recent studies have stressed the importance of the redistribution of blood flow in enhancing the treatment outcome. In the present study, the geometries of a representative hepatic artery and the communicating arcades (CAs) are modeled. An in silico zero-dimensional hemodynamic model is created by characterizing the geometry and the boundary conditions and then is validated in vitro. The role of CAs is assessed by combining 2 cancer scenarios and 2 catheter locations. The importance of the diameter of the CAs is also studied. Results show that occluding a main artery leads to collateral circulation and CAs start to play a role in blood-flow redistribution. In summary, numerical zero-dimensional simulations permit a fast and reliable approach for exploring the blood-flow redistribution caused by the occlusion of a main artery, and this approach could be used during B-TACE planning.

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Durable complete response is achieved by balloon‐occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2022

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In 2013 and 2014, the development of microcatheters with balloons for the 4‐Fr system and new embolization materials provided various options for transarterial chemoembolization (TACE), expanding the range of treatment strategies. At our hospital, balloon‐occluded TACE (B‐TACE), conventional TACE (C‐TACE), and drug‐eluting bead TACE (DEB‐TACE) have been actively performed for hepatocellular carcinoma (HCC). This study compared the local recurrence‐free (LRF) periods of nodules with complete necrosis (TE4) obtained using each treatment method by extracting the nodules evaluated as complete response by the modified Response Evaluation Criteria in Solid Tumors. We performed 580 TACE procedures between June 2013 and April 2019. Among them, 58 HCC nodules in 43 patients, 33 nodules in 30 patients, and 45 nodules in 25 patients were evaluated as having complete necrosis after C‐TACE, DEB‐TACE, and B‐TACE, respectively. The time to local recurrence for each nodule was defined as the LRF period, and the quality of TE4 for each TACE was examined. Factors related to overall survival and the LRF period were determined by univariate and multivariate analyses, and overall survival and the LRF period were analyzed using the Kaplan–Meier method. Multivariate analysis of the LRF period showed that B‐TACE was an independent factor. The median LRF periods were 39.3, 13, and 9.1 months for B‐TACE, C‐TACE, and DEB‐TACE, respectively. Moreover, B‐TACE had a significantly longer LRF period than C‐TACE and DEB‐TACE. Conclusion : There was no significant difference between C‐TACE and DEB‐TACE. The LRF period of nodules with TE4 was the longest with B‐TACE, suggesting that B‐TACE should be used to achieve a radical cure in patients with HCC.

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Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

Abstract: The LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

Cited by 29 publications

References 16 publications

Epirubicin is More Effective than Miriplatin in Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

Epirubicin is More Effective than Miriplatin in Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

Numerical zero‐dimensional hepatic artery hemodynamics model for balloon‐occluded transarterial chemoembolization

Durable complete response is achieved by balloon‐occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

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