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Inicio Radiología (English Edition) Comparison of doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE...
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Vol. 53. Issue 3.
Pages 246-253 (January 2011)
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Vol. 53. Issue 3.
Pages 246-253 (January 2011)
Comparison of doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE) with conventional transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma
Quimioembolización del hepatocarcinoma: partículas cargadas frente a quimioembolización convencional
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M.D. Ferrer Puchol
Corresponding author
lolesferrer@ono.com

Corresponding author.
, C. la Parra, E. Esteban, M. Vaño, M. Forment, A. Vera, O. Cosín
Radiología Intervencionista, Hospital de la Ribera, Alzira, Valencia, Spain
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Abstract
Objective

To compare conventional transarterial chemoembolization (TACE) with doxorubicineluting bead transarterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma, evaluating the tumor response, complications after treatment, and survival.

Material and methods

We present 72 patients diagnosed with hepatocellular carcinoma treated consecutively between January 2000 and December 2009. We studied 25 patients treated with TACE (Group A) and 47 patients treated with DEB-TACE (Group B); adriamycin (doxorubicin) was the chemotherapy agent used in both groups. All patients had compensated cirrhosis of the liver classified on the Child-Pugh score. The results were analyzed according to the RECIST criteria.

Statistical analyses consisted of ANOVA, chi-square tests, Student's t-tests, and Kaplan-Meier log-rank tests.

Results

Patient's age, tumor size, number of tumors, and hepatic reserve were similar in the two groups. The mean number of sessions per patient was 1.32±0.67 in Group A versus 2.13±0.95 in Group B. The mean dose of adriamycin per patient was 50.60±29.95 mg in Group A and 231.91±110.2 mg in Group B. A complete response of the tumor to treatment was observed in 5.6 % of the patients in Group A and in 13.9 % of those in Group B. According to the RECIST criteria, no significant differences were found. DEB-TACE was better tolerated and had fewer immediate complications (p=0.001). No significant differences were found in the survival of patients in the two groups (Group A: mean 686.24 days, median 709 days; Group B: mean 765.32 days, median 672 days.

Conclusion

In patients with unresectable hepatocellular carcinoma, DEB-TACE is safe and better tolerated than conventional TACE; moreover, it seems to lead to greater necrosis of the tumors.

Keywords:
Hepatocellular carcinoma
Intra-arterial chemoembolization
Treatment
Liver
Doxorubicin-eluting beads
Carcinoma
Resumen
Objetivo

Comparar la quimioembolización transarterial (TACE) convencional con la quimioembolización con partículas cargadas (DEB-TACE) para el tratamiento del hepatocarcinoma, valorando la respuesta tumoral, las complicaciones tras el tratamiento y la supervivencia.

Material y métodos

Presentamos 72 pacientes diagnosticados de hepatocarcinoma. El estudio incluye 25 pacientes tratados con TACE (Grupo A) y 47 pacientes tratados con DED-TACE (Grupo B), empleando en ambos grupos adriamicina. Todos los pacientes se tratan consecutivamente desde enero de 2000 hasta diciembre de 2009. Todos presentaban una cirrosis en estadio Child-Pugh compensada. Los resultados se estudiaron conforme al criterio RECIST.

El estudio estadístico consistió en ANOVA, Chi 2, T-Test y estudio de Kaplan-Meier (test de Log-Rank).

Resultados

La edad, el tamaño, el número de tumores y la reserva hepática en los dos grupos de pacientes fueron estadísticamente similares. El número de sesiones por paciente fue: Grupo A media 1,32±0,67 veces, Grupo B media 2,13±0,95 veces. La media de dosis de adriamicina por paciente fue: 50,60±29,95 mg en grupo A y 231,91±110,2 mg en grupo B. Se observó una respuesta completa del tumor en 5,6 % en el grupo A y 13,9 % en el grupo B. Conforme al sistema RECIST no se encontraron diferencias estadísticamente significativas. La DEB-TACE fue mejor tolerada con menos complicaciones inmediatas (p=0,001). No se encontraron diferencias significativas en la supervivencia entre los dos grupos. grupo A: media 686,24, mediana 709 días, y grupo B: media 765,32, mediana 672 días.

Conclusión

En los pacientes con hepatocarcinoma irresecable, la quimioembolización con partículas cargadas de adriamicina es segura y mejor tolerada que la quimioembolización convencional y parece producir una mayor necrosis tumoral.

Palabras clave:
Hepatocarcinoma
Quimioembolización intraarterial
Terapéutica
Hígado
Microesferas de adriamicina
Carcinoma

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