Transarterial chemoembolization using gelatin sponges or microspheres plus lipiodol-doxorubicin versus doxorubicin-loaded beads for the treatment of hepatocellular carcinoma

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

Abstract

Objective: To retrospectively compare treatment of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) using gelatin sponges or microspheres plus lipiodol-doxorubicin vs. doxorubicin-loaded drug-eluting beads (DEB).

Materials and methods: A total of 158 patients with HCC received TACE from November 2010 to November 2011 were enrolled in this study, including 64 (40.5%) received TACE with lipiodol-doxorubicin and gelatin sponges (group A), 41 (25.9%) received TACE with lipiodol-doxorubicin and microspheres (group B), and 53 (33.5%) received TACE with doxorubicin-loaded DEB (group C). Tumor response and adverse events (AEs) were evaluated.

Results: No significant difference was found at baseline among the three groups. The doxorubicin dosage in group C was significantly (p < 0.001) higher compared to the dose used in groups A or B (median, 50 mg vs. 31 mg or 25 mg). Significantly (p < 0.001) more patients in group C achieved complete response compared to those in groups A or B (32.1% vs. 6.3% or 2.4%). Significantly (p < 0.001) less patients in group C had progressive disease compared to those in groups A or B (34.0% vs. 57.8% or 68.3%). Minor AEs were more common in groups A and B compared to group C, with rates of 54.7%, 34.1%, and 5.7%, respectively.

Conclusion: In patients with HCC, TACE with DEB offers better safety and efficacy profiles compared to either TACE with gelatin sponges or TACE with microspheres.

Keywords: Chemoembolization; Doxorubicin; Drug-eluting bead; Hepatocellular carcinoma; Microsphere.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival curves for three groups. Last progression event occurred in 16th month. Therefore, progression-free rate was not available after 16 months. Log-rank test shows that group C patients had significantly (p < 0.001) higher progression-free rate compared to group A or group B. Group A: TACE with gelatin sponge; Group B: TACE with Embosphere; Group C: TACE with DEB. DEB = drug-eluting bead, TACE = transarterial chemoembolization

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