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Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients

04/05/2018 -  

​Filipe Veloso Gomes, MBChB, BSc, João A. Oliveira, MD, Mariana Tomé Correia, MD, Nuno Vasco Costa, MD, João Abrantes, MD, Daniel Torres, MD, Pedro Pereira, MD, Ana Isabel Ferreira, MD, José Hugo Luz, MD, Erik Spaepen, MSc, Tiago Bilhim, MD, PhD, and Élia Coimbra, MD

Abstract


Purpose

To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC).


Materials and Methods

A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan–Meier method.


Results

Median follow-up time was 11.9 months (95% confidence interval, 11.0–13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncturesite hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progressionfree survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response.


Conclusions

Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%.


Source: https://doi.org/10.1016/j.jvir.2018.02.004