Transarterial Chemoembolization Using Gelatin Sponges or Microspheres Plus Lipiodol-Doxorubicin versus Doxorubicin-Loaded Beads for the Treatment of Hepatocellular Carcinoma

Liu, Yi Sheng; Ou, Ming Ching; Tsai, Yi Shan; Lin, Xi Zhang; Wang, Chien-Kuo; Tsai, Hann-Huei; Chuang, Ming Tsung

doi:10.3348/kjr.2015.16.1.125

Cited by 40 publications

(41 citation statements)

References 45 publications

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“…DEB-TACE has been reported to have a more stable phar-macokinetics profile than C-TACE in both animal and clinical trials. 6,7,16,17 An earlier trial comparing C-TACE and DEB-TACE showed that complications associated with the procedure and the effusion of anticancer drugs and hepatic dysfunction were less likely to occur in the DEB-TACE group. In addition, the objective response rate and disease control rate of HCC were found to be better in the DEB-TACE group.…”

Section: Discussionmentioning

confidence: 99%

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Lee¹,

Joo²,

Yum³

et al. 2017

JLC

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Background/Aims: To retrospectively compare conventional and drug-eluting beads transarterial chemoembolization (C-TACE and DEB-TACE) for treatment of hepatocellular carcinoma (HCC) at very early and early stages. Methods:We retrospectively compared patients treated with C-TACE (n=115) or DEB-TACE (n=103) from September 2009 to May 2016. All patients were in a very early (stage 0) or early stage (stage A) of the Barcelona Clinic Liver Cancer (BCLC) staging system, and all had Child-Pugh class A and ≤B7 liver status. Approval by the institutional review board was waived because the study was retrospective. The following parameters were evaluated: severe pain and bradycardia during TACE, post-embolization syndrome (PES), liver function change, complications, target tumor response, and conversion to another treatment modality. Numeric differences were assessed by the independent Student's t-test for continuous variables and by chi-square test for categorical variables.Results: Severe intractable pain and bradycardia during the TACE procedure were significantly more frequent in the C-TACE group than in the DEB-TACE group (P<0.001). The incidence and duration of PES were significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The increase in liver enzymes was significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The deterioration of the Child-Pugh class was significantly higher in the C-TACE group than in the DEB-TACE group (P=0.006). There was no significant difference in serious complications except localized bile duct dilatation between the groups. There was no significant difference between the groups in tumor response at both immediate and 1-year assessment. The conversion rate to other treatment modalities was significantly higher in the DEB-TACE group than in the C-TACE group (P<0.001).Conclusions: DEB-TACE is better than C-TACE in terms of procedural safety as initial treatment in a very early or early stage of HCC. (J Liver Cancer 2017;17:144-152)

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Section: Discussionmentioning

confidence: 99%

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Lee¹,

Joo²,

Yum³

et al. 2017

JLC

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“…Nine studies involving 909 subjects reported the disease control rate (19,21,25,26,30,32,35,36,38). Of those studies, 2 were published by the same group.…”

Section: Comparison Of the Disease Control Ratementioning

confidence: 99%

“…The overall response rate (ORR) was reported in 13 studies (12,17,19,21,25,26,(30)(31)(32)34,35,36,38). Due to the high heterogeneity found among the included studies ( χ 2 = 6.67, d.f.…”

Section: Comparison Of the Objective Response Ratementioning

confidence: 99%

The clinical safety and efficacy of conventional transcatheter arterial chemoembolization and drug-eluting beads-transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: A meta-analysis

Han

Yang

Zhang

et al. 2019

BST

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Hepatocellular carcinoma (HCC) is the 6th most common malignant tumor, and it ranks 3rd in terms of cancer-related deaths, with an overall survival rate of 3-5% (1). Unfortunately, its incidence is still rising around the world (2). Hepatitis viral infections and alcoholism are the dominant factors that trigger HCC. Diabetes, obesity, and metabolic disorders are also associated with HCC (3). Common treatments include resection, ablation, chemoembolization, radiotherapy, and chemotherapy (4). The preferred approach, surgical resection can increase the 5-year survival rate to 60% (5). However, most patients exhibit nonspecific clinical symptoms, so when the condition is ultimately diagnosed they are unable to undergo radical surgery (6). Only 10-15% of patients with HCC are eligible for surgical resection. As a downstaging therapy, transcatheter arterial chemoembolization (TACE) has been widely used to treat unresectable HCC, and it can improve the overall survival of patients with HCC (7,8). Summary Transcatheter arterial chemoembolization (TACE) plays an important role in the treatment of unresectable liver cancer. We conducted this meta-analysis to compare the clinical safety and efficacy of conventional TACE (C-TACE) and drug-eluting beads (DEB)-TACE. A search for those procedures was performed using the PubMed, EMBASE, and Cochrane Library databases. A meta-analysis of patients who underwent C-TACE or DEB-TACE was conducted. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Of 334 studies, 30 were analyzed. The complete response rate, disease control rate, objective response rate, 3-year survival rate, and non-response rate were significantly higher in patients who underwent DEB-TACE than those in patients who underwent C-TACE. The 1-year survival rate, 2-year survival rate, 30-day mortality rate, complete response rate, disease control rate, complete necrosis rate, non-response rate, objective response rate, progressive disease rate, and recurrence did not differ significantly between patients who underwent C-TACE and patients who underwent DEB-TACE. Patients who undergo DEB-TACE might have a higher complete response rate, disease control rate, and 3-year survival rate than patients who undergo C-TACE. Safety did not differ significantly between C-TACE and DEB-TACE.

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“…Among 16 articles that retrospectively analyzed DEB‐TACE versus cTACE, five described the superiority of DEB‐TACE, three showed an advantage of cTACE, and the remaining eight showed equivalent effect or adverse events. Individual evaluation of objective response rate, TTP, OS, and adverse events, did not show definite advantages of DEB‐TACE over cTACE in these retrospective studies.…”

Section: Transcatheter Arterial Therapymentioning

confidence: 99%

Recent advances in medical management of hepatocellular carcinoma

Ikeda

2018

Hepatology Research

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Transcatheter arterial therapies for hepatocellular carcinoma (HCC) have developed during the last decade. A fine powder formulation of cisplatin and the new platinum agent miriplatin became standard medicines in addition to anthracyclines in transcatheter arterial chemoembolization (TACE) in Japan. Recent prospective and retrospective studies supported the usefulness of platinum agents as a chemotherapeutic at the time of varied TACE therapy. Although balloon-occluded TACE is an effective therapy for localized HCC and drug-eluting microspheres seemed to show a higher response rate in certain HCCs, the definite advantages of those procedures still remain uncertain. Intermediate stage HCC, or Barcelona Clinic Liver Cancer stage B, is regarded as a heterogeneous category with a wide spectrum of tumors and patients, and several subclassifications of the stage have been proposed to show different prognoses; there are also different recommended therapies in each subgroup. Authors have subclassified patients based on combinations of tumor size, tumor number, and liver function, with or without performance status. Because of differences of available medical resources and techniques in treatment procedures between countries, the most ideal and useful subgrouping remains inconclusive at present. Recently, a few systemic chemotherapies proved to be effective for advanced stage HCC in phase III studies: lenvatinib as the first line of therapy, and regorafenib, cabozantinib, and ramucirumab as second-line therapy. Other molecular-targeted and immune-oncological medicines are expected to follow in the near future. Some studies have suggested an advantage of early introduction of moleculartargeted therapy for TACE-resistant HCC in the intermediate stage.

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Transarterial Chemoembolization Using Gelatin Sponges or Microspheres Plus Lipiodol-Doxorubicin versus Doxorubicin-Loaded Beads for the Treatment of Hepatocellular Carcinoma

Cited by 40 publications

References 45 publications

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

The clinical safety and efficacy of conventional transcatheter arterial chemoembolization and drug-eluting beads-transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: A meta-analysis

Recent advances in medical management of hepatocellular carcinoma

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