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Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma: comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study

 Seungsoo Lee  ;  Kyoung Min Kim  ;  Shin Jae Lee  ;  Kwang-Hun Lee  ;  Do Yun Lee  ;  Man Deuk Kim  ;  Do Young Kim  ;  Seung Up Kim  ;  Jong Yun Won 
 ACTA RADIOLOGICA, Vol.58(2) : 131-139, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Angiography ; Antibiotics, Antineoplastic/administration & dosage ; Antineoplastic Agents/administration & dosage ; Carcinoma, Hepatocellular/therapy* ; Chemoembolization, Therapeutic/adverse effects* ; Chemoembolization, Therapeutic/methods* ; Doxorubicin/administration & dosage ; Ethiodized Oil/administration & dosage ; Female ; Hepatic Artery/diagnostic imaging ; Hepatic Artery/pathology* ; Humans ; Liver Neoplasms/therapy* ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome
Drug-eluting bead ; doxorubicin ; hepatic arterial damage ; transarterial chemoembolization
Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group ( P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group ( P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group ( P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Do Young(김도영)
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Lee, Shin Jae(이신재)
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