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Safety and efficacy of balloon‐occluded transcatheter arterial chemoembolization using miriplatin for hepatocellular carcinoma

20/04/2018 -  

​Hirotaka Arai et al Gunma University Graduate School of Medicine, Maebashi, Japan

Abstract

Aim

Balloon‐occluded transcatheter arterial chemoembolization (B‐TACE) using a microballoon catheter was performed to administrate miriplatin, and the early therapeutic efficacy and safety of the procedure were evaluated.


Methods

Out of 158 patients who received miriplatin using B‐TACE for hepatocellular carcinoma, 49 patients with a single lesion at either stage I or II (according to the Liver Cancer Study Group of Japan) were evaluated in comparison with 48 matched patients who received miriplatin using conventional TACE (C‐TACE).


Results

The mean total dose and median dose of miriplatin in each group were 32.5 ± 31.7 mg and 20 mg (C‐TACE) and 50.1 ± 31.3 mg and 40 mg (B‐TACE), respectively (P < 0.01). The treatment effect (TE) on the target nodule classified as TE4, TE3, TE2 or TE1 was 39.6%, 33.3%, 25.0% and 2.1%, respectively, in the C‐TACE group, and 55.1%, 38.8%, 4.1% and 2.0%, respectively, in the B‐TACE group. Therefore, the TE was significantly higher in the B‐TACE group (P < 0.05). Although abdominal blood tests revealed adverse, increased levels of serum alanine aminotransferase (ALT) in a significantly higher number of B‐TACE‐treated patients, serum ALT levels returned to baseline levels in all patients within 1 month. There were no significant differences in clinical symptoms between the two groups.


Conclusion

Compared with C‐TACE, B‐TACE significantly improved cancer nodule control, and it was satisfactory in terms of safety. B‐TACE is an effective procedure that enhances the effects of catheterization with miriplatin.