Transarterial chemoembolization with smaller beads: midterm clinical outcomes

Cura, Marco; Marashi, K.; Sacks, Josh; Meler, James D.; Daoud, Yahya

doi:10.1016/j.jvir.2014.12.185

Cited by 2 publications

(1 citation statement)

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“…Heithaus et al recently reported on midterm outcomes from 94 DEB-TACE sessions using 70–150 µm beads in which disease control (DC = CR + PR + SD) was achieved in 95 % of focal and 96 % of small tumors versus 61 % of multifocal ( P = 0.04) and 55 % of large tumors ( P = 0.0009). They concluded the treatment was safe with no grade 4/4 complications, 88 % of patients discharged within 24 h and demonstrated antitumoural response and survival benefits [ 49 ]. Rao et al demonstrated the safety and feasibility of performing a DEB-TACE procedure in 31 consecutive patients treated with 70–150 µm beads, as an outpatient procedure with same-day discharge for 88 % of patients given their observations of decreased symptoms of PES [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

DC BeadM1™: towards an optimal transcatheter hepatic tumour therapy

Lewis

Dreher

O’Byrne

et al. 2015

J Mater Sci: Mater Med

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Clinical use of DC Bead™ loaded with doxorubicin (DEBDOX™) or irinotecan (DEBIRI™), for the treatment of primary and secondary tumours of the liver respectively, is showing great promise. Recently there has been a tendency to select smaller bead size ranges to treat tumours in an effort to allow more drug dose to be administered, improve tumoural penetration and resultant drug delivery and tumour coverage. Herein we describe the development and performance characterisation of a new DC Bead size range (DC BeadM1TM, 70–150 μm) capable of an increased bead delivery in the distal vasculature, corresponding to greater tumour coverage and drug dose delivered. Both unloaded and drug loaded DC BeadM1 were shown to have a greater density of distal volume of penetration although the ultimate distal level of penetration was the same as that of the 100–300 µm beads in an in vitro penetration model. Elution of doxorubicin was slower than irinotecan elution, but it was similar when comparing the same drug elution from 70 to 150 µm compared to 100–300 µm beads. Radiopaque versions of 70–150 and 100–300 µm beads were prepared in order to evaluate distribution ex vivo using µ-CT and doxorubicin distribution using epifluorescent microscopy. Liver distribution of the radiopaque versions of the beads was shown to be more distal and efficient at filling smaller vessels with the DC BeadM1 and correspondingly more beads were found per vessel histologically with a larger area of drug coverage with the smaller size range. This study indicates that the smaller (70–150 μm) beads should permit an increased dose of drug to be administered to both hypervascular and hypovascular tumours as compared to 100–300 µm beads.

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Section: Discussionmentioning

confidence: 99%