Transarterial Chemoembolization (TACE) using Mitomycin and Lipiodol with or without Degradable Starch Microspheres for Hepatocellular Carcinoma: comparative study

Zielsetzung:

Evaluation of survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols in the treatment of HCC patients.

Material und Methoden:

99 patients (mean age: 63.6 years), 78 male (78.8%) and 21 female (21.2%) with HCC were repeatedly treated with chemoembolization in 4-week-intervals. Eighty-eight patients had BCLC-Stage-B, in 11 patients chemoembolization was performed for bridging (BCLC-Stage-A). In total, 667 chemoembolization-treatments were performed (mean 6.7 treatments/patient). The administered chemotherapeutic agent included mitomycin. For embolization, lipiodol only (n = 51;51.5%), mean age 63,8 years, 38 male and 13 female, or lipiodol plus degradable starch microspheres (DSM) (n = 48;48.5%), mean age 63,4 years, 40 male and 8 female, was used. The local response of the tumors was assessed by MRI using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) Patient survival times were evaluated using Kaplan-Meier curves and log-rank tests.

Ergebnisse:

The local tumor control in the lipiodol-group was: PR (partial response) in 11 (21.6%), SD (stable disease) in 32 (62.7%) and PD (progressive disease) in 8 cases (15.7%). In the lipiodol-DSM-group, the PR was encountered in 14 cases (29.2%), SD in 22 (45.8%) and PD in 12 (25.0%) (p = 0.211). The median survival of patients after chemoembolization with lipiodol was 25 months and in the lipiodol-DSM-group 28 months (p = 0.845).

Schlussfolgerungen:

There was no statistical significant benefit reported of using lipiodol and DSM in comparison of using lipiodol-only for chemoembolization of HCC in achieving local control and survival data. Only a slight trend for benefit of using lipiodol and DSM was shown.