No lipiodol, no beads—another transcatheter arterial chemoembolization (TACE) with fine cisplatin powder and porous gelatin particles for TACE‐naïve, multifocal, up‐to‐seven out hepatocellular carcinoma

Abstract

AimThe Japanese Interventional oncology group (JIVROSG) showed the efficacy and safety of nonselective transarterial chemoembolization (TACE) with fine cisplatin powder (diamminedichloroplatinum; DDP‐H) (65 mg/m2) and porous gelatin particles (DDP‐H TACE) without lipiodol for extensive multifocal hepatocellular carcinoma (HCC). However, there are no studies on this method following the JIVROSG study. Therefore, we aimed to evaluate the efficacy of this new DDP‐H TACE and its effect on liver function.MethodsWe retrospectively reviewed the medical records of TACE‐naïve patients with multifocal HCC (Child‐Pugh class A, up‐to‐seven out, no prior history of systemic therapy) who underwent whole‐liver DDP‐H TACE between January 2006 and December 2019.ResultsSixty patients were included in this study. The median age of the patients was 71 (range, 35–88) years. The median maximum size of tumors was 26 (range, 8–184) mm; 86.7% of patients met the up‐to‐11 criteria out. The overall survival duration was 30.3 months. At the time of initial evaluation (median, 45 days), the overall response rate was 65.0%; the disease control rate was 86.7% based on the modified response evaluation criteria in solid tumors guideline. Although nine patients' liver function had deteriorated to Child‐Pugh class B at initial evaluation, six of them recovered to Child‐Pugh class A. Only three patients (5%) showed permanently impaired liver function.ConclusionsWhole‐liver DDP‐H TACE without lipiodol or beads effectively reduced tumors and preserved liver function.