J Liver Cancer.  2023 Mar;23(1):166-176. 10.17998/jlc.2023.02.08.

Use of doxorubicin-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein invasion: a prospective study

• Yu SJ
• Lee YB
• Cho EJ
• Lee JH
• Kim HC
• Chung JW
• Yoon JH
• Kim YJ

• KMID: 2540829
• DOI: http://doi.org/10.17998/jlc.2023.02.08

Abstract

Background
/Aim: To evaluate the applicability of transarterial chemoembolization (TACE) treatment with doxorubicin drug-eluting beads (DEBs) in advanced hepatocellular carcinoma (HCC) patients with portal vein invasion (PVI).
Methods
This prospective study was approved by the institutional review board and informed consent was obtained from all participants. A total of 30 HCC patients with PVI received DEB-TACE between 2015 and 2018. The following parameters were evaluated: complications during DEB-TACE, abdominal pain, fever, and laboratory outcomes, including liver function change. Overall survival (OS), time to progression (TTP), and adverse events were also analyzed and assessed.
Results
DEBs measuring 100–300 μm in diameter were loaded with doxorubicin (150 mg per procedure). There were no complications during DEB-TACE and no significant differences in the levels of prothrombin time, serum albumin, or total bilirubin at follow-up compared to baseline. The median TTP was 102 days (95% confidence interval [CI], 42–207 days) and the median OS was 216 days (95% CI, 160–336 days). Three patients (10%) had severe adverse reactions, including transient acute cholangitis (n=1), cerebellar infarction (n=1), and pulmonary embolism (n=1), but no treatment-related death occurred.
Conclusions
DEB-TACE may be a therapeutic option for advanced HCC patients with PVI.

Keyword

Carcinoma, hepatocellular; Chemoembolization, therapeutic; Sorafenib; Portal vein

Figure

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  Figure 1. Study design and CONSORT diagram of patient flow.

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  Figure 2. Kaplan-Meier curves of (A) time to progression, (B) progression-free survival, and (C) overall survival.

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  Figure 3. Kaplan–Meier curves of (A) time to progression, (B) progression-free survival, and (C) overall survival according to subgroup analysis (the disease control group [PR+SD] vs. the other group [PD+not applicable]). PD; progressive disease, PR; partial response, SD; stable disease.

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Reference

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