Clinical safety and tumor response rate of DEB-TACE for the treatment of hepatocellular carcinoma

Abstract

OBJECTIVE: To assess the tumor response rate and clinical safety of transarterial chemoembolization using drug-eluting beads (DEB-TACE) in patients with hepatocellular carcinoma.MATERIALS AND METHODS: Between September 2009 and January 2011, eighty-one patients with 100 HCCs were included in this study. All patients underwent pre-procedural MDCT or magnetic resonance imaging for evaluation of tumor stage. Four experienced interventional radiologists had performed DEB-TACE for hypervascular HCC. Before and after treatment, liver function status (Child-Pugh class) and tumor stage (BCLC and mUICC criteria) were evaluated. MDCT and MRI were performed 4~8 weeks after DEB-TACE to evaluation of tumor response. And, statistical correlation was calculated between angiographic findings and tumor response. Also, relation tumor stage and tumor response was calculated. Finally, post-procedural complications were evaluated by symptoms and image findings.RESULTS: For total of 81 patients, 71 were Child-Pugh class A and 10 were Child-Pugh class B before treatment, and 67 were Child-Pugh class A, 13 were Child-Pugh class B and 1 were Child-Pugh class C after treatment. For a total of 100 treated HCCs, immediate complete response (CR) according to mRECIST and EASL was seen in 74 lesions. Partial response (PR) lesions were 14 according to mRECIST and 13 in EASL, stable disease (SD) were 5 according to mRECIST and 6 in EASL, and disease progression (PD) were 7 according two response criteria. Tumor progression free survival rate were 65.2% during 1-year follow-up. There was no statistical significance between tumor stage and tumor response. Of angiographic findings, feeder hypertrophy, neovascularization and multiple feeder were correlated with tumor response, showing statistical significance. Of total 81 patients, localized bile duct dilatation were shown in 39 patients (48.1%), peritumoral parenchymal ischemic change were shown in 10 patients (12.4%) and post-embolization syndrome were shown in 7 patients (8.6%).CONCLUSION: DEB-TACE was considered as a safe modality for the treatment of HCC, and showed acceptable tumor response rate as well as tumor progression free rate in this mid-term result.