Predictive Factor of Local Recurrence after Balloon-Occluded TACE with Miriplatin (MPT) in Hepatocellular Carcinoma

Abstract

BackgroundMiriplatin (MPT) is a novel platinum complex used in TACE that shows promise for the treatment of hepatocellular carcinoma (HCC). However, rapid washout has been reported in some cases. Therefore, various methods of administration with MPT have been attempted to increase its therapeutic efficacy. One hopeful method is balloon-occluded TACE (B-TACE), but the therapeutic efficacy of B-TACE with MPT has not been evaluated.AimTo investigate the treatment outcomes and factors involved in local recurrence after B-TACE with MPT in HCC.MethodsThis study included 51 patients (55 nodules) with HCC lesions equal or less than 5 cm in diameter who underwent B-TACE with MPT between January 2012 and June 2013. Local recurrence after B-TACE with MPT and factors associated with local recurrence were evaluated.ResultsThe overall local recurrence rate was 11.1% at 6 months and 26.2% at 12 months. The local recurrence rate did differ significantly depending on CT values immediately after B-TACE with MPT. Multivariate analysis also showed that the CT value after B-TACE with MPT was the only factor related to local recurrence after B-TACE.ConclusionsB-TACE with MPT achieves relatively good local control of HCC. The plain CT value immediately after B-TACE with MPT is a predictive factor for local recurrence. In patients with unsatisfactory CT values, locoregional therapy or additional treatment is required.

Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases

“…This is possibly because the number of patients in our EPIR-C-TACE group who could be treated with superselective TACE might have been fewer than in previous reports. The local control rate after MPT-B-TACE in the present study (median time to local recurrence, 8.3 M) might be comparable with previous reports regarding C-TACE using MPT and EPIR [14,32], but the present data tended to be lower than in previous reports regarding MPT-B-TACE [28,33,34]. This might be possibly caused by patient and tumor characteristics.…”

Transarterial Chemoembolization with and without Microballoon Occlusion for Hypovascular Hepatocellular Carcinoma

“…Further, Ishikawa et al reported that occlusion of the hepatic artery caused hemodynamic changes, and injection under these changes induced more effective accumulation of iodized oil [8]. In the present case, compared with CTA without balloon occlusion, arteriogram and CTA with balloon occlusion showed slight arterial enhancement, and much stronger and broader enhancement of the surrounding area of the tumor.…”

“…Hypovascular HCC has a poor arterial blood supply, so it is difficult to control with conventional TACE (C-TACE) [4,6]. Balloon-occluded TACE (B-TACE), which induces the dense accumulation of iodized oil in HCC to prevent proximal migration and leakage of iodized oil by occlusion of the hepatic artery, is a promising method for improving the efficacy of C-TACE [7,8]. Here, we report a case in which good therapeutic control of a hypovascular tumor suspected as poorly differentiated HCC (pHCC) was achieved using B-TACE in addition to C-TACE.…”

Hemodynamic Changes on Cone-Beam Computed Tomography during Balloon-Occluded Transcatheter Arterial Chemoembolization Using Miriplatin for Hepatocellular Carcinoma: A Preliminary Study

“…We previously reported that B-TACE with MPT achieved relatively good local control of HCC (local recurrence rate, 11.1% at 6 months and 26.2% at 12 months) [5] . The mechanism of improved local control can be explained by the presence of anastomotic vessels, viscosity of lipiodol emulsion, and difference in size between the peripheral vessels in normal parenchyma and the vessels feeding into the HCC.…”

“…We have previously reported that the Hounsfield unit value of a tumor obtained from conventional CT immediately after B-TACE with MPT is predictive of the recurrence risk [5] .…”