Transarterial Chemoembolization of Child-A hepatocellular carcinoma: Drug-eluting bead TACE (DEB TACE) vs. TACE with Cisplatin/Lipiodol (cTACE)
Philipp Wiggermann, Dominik Sieron, Christiane Brosche, Thomas Brauer, Fabian Scheer, Ivan Platzek, Wojciech Wawrzynek, Christian Stroszczynski
Med Sci Monit 2011; 17(4): CR189-195
Background: This study is an outcome evaluation of the Drug-Eluting-Bead-Chemoembolization (DEB TACE) compared to conventional TACE (cTACE) with Cisplation and Lipiodol in patients with hepatocellular carcinoma (HCC) and Child-Pugh A Cirrhosis.
Material/Methods: A comparison of interventional therapy with either cTACE or DEB-TACE of 22 patients each with unresectable HCC and Child-Pugh A Cirrhosis was carried out. A comparison of therapy-associated complications, tumour response rates and mean survival was performed. Tumour response was evaluated in accordance with the European Association for the Study of the Liver (EASL) response criteria by two radiologists in consensus reading.
Results: The choice of TACE procedure (DEB TACE/cTACE) had no significant impact on therapy-associated complications. Objective Response (OR, complete response + partial response) for DEB-TACE was 22.7%; a further 68.2% was stable disease (SD). The respective response rates for the cTACE were OR 22.7 and SD 31.8%. Thus disease control was not significantly increased for DEB TACE (p=0.066). After DEB-TACE mean survival was significantly prolonged with 651±76 days vs. 414±43 days for cTACE (p=0.01).
Conclusions: Associated with a similar safety profile and an at least comparable tumour response, the DEB-TACE is a method of treatment for HCC that has the potential to improve mean survival compared to cTACE with Cisplatin/Lipiodol.
Keywords: Liver Cirrhosis - drug therapy, Kaplan-Meier Estimate, Humans, Female, Ethiodized Oil - therapeutic use, Drug-Eluting Stents - adverse effects, Cisplatin - therapeutic use, Chemoembolization, Therapeutic - adverse effects, Catheterization, Carcinoma, Hepatocellular - drug therapy, Arteries - pathology, Aged, 80 and over, Aged, Liver Neoplasms - drug therapy, Magnetic Resonance Imaging, Male, Middle Aged, Tomography, X-Ray Computed