Abstract
Objective: To investigate whether balloon-occluded transcatheter arterial chemoembolization (b-TACE) can produce a more dense accumulation of iodized oil in various stages of hepatocellular carcinoma (HCC), from single to uncountable, to overcome inferior local control. Materials and Methods: We studied 27 patients with HCC, including single to uncountable multiple lesions, who underwent b-TACE between August 2013 and April 2015. Dynamic CT was performed at baseline and 1-3 months after b-TACE. The treatment effect (TE) after b-TACE was evaluated using the Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan. Results: In the countable HCC group, contrast-enhanced CT demonstrated RECICL TE4 in 43.8% (14/32), TE3 in 12.5% (4/32), TE2 in 37.5% (12/32), and TE1 in 6.3% (2/32) of patients. For the TACE-naïve cohort, the objective response rate was 52.9%. The objective response rate was 60% for the previously TACE-treated cohort. In the uncountable multiple HCC group, the objective response rate was 0% (0/10), with progressive disease in 90% (9/10) of patients. Conclusion: Our observations suggested that b-TACE did not reduce the efficacy of retreatment for HCC with an insufficient outcome from conventional TACE, but it could not improve the efficacy of treatment for uncountable multiple HCCs.
Journal Section:
Clinical Study
References
1.
Llovet JM, Real MI, Montana X, et al: Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002;359:1734-1739.
[PubMed]
2.
Marelli L, Stigliano R, Triantos C, et al: Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol 2007;30:6-25.
[PubMed]
3.
Llovet JM, Bruix J: Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology 2003;37:429-442.
[PubMed]
4.
Takayasu K, Arii S, Ikai I, et al: Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8,510 patients. Gastroenterology 2006;131:461-469.
[PubMed]
5.
Sergio A, Cristofori C, Cardin R, et al: Transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): the role of angiogenesis and invasiveness. Am J Gastroenterol 2008;103:914-921.
[PubMed]
6.
Lencioni R: Chemoembolization for hepatocellular carcinoma. Semin Oncol 2012;39:503-509.
[PubMed]
7.
Lencioni R: Chemoembolization in patients with hepatocellular carcinoma. Liver Cancer 2012;1:41-50.
[PubMed]
8.
Minami Y, Yagyu Y, Murakami T, Kudo M: Tracking navigation imaging of transcatheter arterial chemoembolization for hepatocellular carcinoma using three-dimensional cone-beam CT angiography. Liver Cancer 2014;3:53-61.
[PubMed]
9.
Minami Y, Kudo M: Therapeutic response assessment of transcatheter arterial chemoembolization for hepatocellular carcinoma: ultrasonography, CT and MR imaging. Oncology 2013;84(suppl 1):58-63.
[PubMed]
10.
Minami Y, Kudo M, Kawasaki T, et al: Transcatheter arterial chemoembolization of hepatocellular carcinoma: usefulness of coded phase-inversion harmonic sonography. AJR Am J Roentgenol 2003;180:703-708.
[PubMed]
11.
Lee JK, Chung YH, Song BC, et al: Recurrences of hepatocellular carcinoma following initial remission by transcatheter arterial chemoembolization. J Gastroenterol Hepatol 2002;17:52-58.
[PubMed]
12.
Irie T, Kuramochi M, Takahashi N: Dense accumulation of lipiodol emulsion in hepatocellular carcinoma nodule during selective balloon-occluded transarterial chemoembolization: measurement of balloon-occluded arterial stump pressure. Cardiovasc Intervent Radiol 2013;36:706-713.
[PubMed]
13.
Arai H, Abe T, Takayama H, et al: Safety and efficacy of balloon-occluded transcatheter arterial chemoembolization using miriplatin for hepatocellular carcinoma. Hepatol Res 2015;45:663-666.
[PubMed]
14.
Ogawa M, Takayasu K, Hirayama M, et al: Efficacy of a microballoon catheter in transarterial chemoembolization of hepatocellular carcinoma using miriplatin, a lipophilic anticancer drug: short-term results. Hepatol Res 2015, Epub ahead of print.
[PubMed]
15.
Golfieri R, Cappelli A, Cucchetti A, et al: Efficacy of selective transarterial chemoembolization in inducing tumor necrosis in small (<5 cm) hepatocellular carcinomas. Hepatology 2011;53:1580-1589.
[PubMed]
16.
Livraghi T, Brambilla G, Carnaghi C, et al: Is it time to reconsider the BCLC/AASLD therapeutic flow-chart? J Surg Oncol 2010;102:868-876.
[PubMed]
17.
Kudo M, Kubo S, Takayasu K, et al: Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan (2009 revised version). Hepatol Res 2010;40:686-692.
[PubMed]
18.
Kudo M, Izumi N, Kokudo N, et al: Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Dig Dis 2011;29:339-364.
[PubMed]
19.
Llovet JM, Ducreux M, et al: EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56:908-943.
[PubMed]
20.
Park JW, Amarapurkar D, Chao Y, et al: Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC). Liver Int 2013;33:327-337.
[PubMed]
21.
Ogasawara S, Chiba T, Ooka Y, et al: Efficacy of sorafenib in intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization. Oncology 2014;87:330-341.
[PubMed]
22.
Raoul JL, Gilabert M, Piana G: How to define transarterial chemoembolization failure or refractoriness: a European perspective. Liver Cancer 2014;3:119-124.
[PubMed]
23.
Kim HY, Park JW: Clinical trials of combined molecular targeted therapy and locoregional therapy in hepatocellular carcinoma: past, present, and future. Liver Cancer 2014;3:9-17.
[PubMed]
24.
Peck-Radosavljevic M: Drug therapy for advanced-stage liver cancer. Liver Cancer 2014;3:125-131.
[PubMed]
25.
Bruix J, Llovet JM, Castells A, et al: Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma: results of a randomized, controlled trial in a single institution. Hepatology 1998;27:1578-1583.
[PubMed]
26.
Kudo M, Matsui O, Izumi N, et al: JSH Consensus-Based Clinical Practice Guideline for the Management of Hepatocellular Carcinoma: 2014 Update by the Liver Cancer Study Group of Japan. Liver Cancer 2014;3:458-468.
[PubMed]
27.
Kudo M, Matsui O, Izumi N, et al: Transarterial chemoembolization failure/refractoriness: JSH-LCSGJ criteria 2014 update. Oncology 2014;87(suppl 1):22-31.
[PubMed]
28.
Yamashita T: Current status of hepatocellular carcinoma treatment in Japan: hepatic arterial infusion chemotherapy. Clin Drug Invest 2012;32(suppl 2):15-23.
[PubMed]
29.
Kudo M: Surveillance, diagnosis, treatment, and outcome of liver cancer in Japan. Liver Cancer 2015;4:39-50.
[PubMed]
30.
Ikeda M, Okusaka T, Furuse J, et al: A multi-institutional phase II trial of hepatic arterial infusion chemotherapy with cisplatin for advanced hepatocellular carcinoma with portal vein tumor thrombosis. Cancer Chemother Pharmacol 2013;72:463-470.
[PubMed]
31.
Ueshima K, Kudo M, Takita M, et al: Hepatic arterial infusion chemotherapy using low-dose 5-fluorouracil and cisplatin for advanced hepatocellular carcinoma. Oncology 2010;78(suppl 1):148-153.
[PubMed]
32.
Ueshima K, Kudo M, Nagai T, et al: Combination therapy with S-1 and pegylated interferon alpha for advanced hepatocellular carcinoma. Oncology 2008;75(suppl 1):106-113.
[PubMed]
33.
Obi S, Yoshida H, Toune R, et al: Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. Cancer 2006;106:1990-1997.
[PubMed]
34.
Nagano H, Miyamoto A, Wada H, et al: Interferon-alpha and 5-fluorouracil combination therapy after palliative hepatic resection in patients with advanced hepatocellular carcinoma, portal venous tumor thrombus in the major trunk, and multiple nodules. Cancer 2007;110:2493-2501.
[PubMed]
© 2015 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2015
You do not currently have access to this content.
