Objective: The aims of this study were to: a) evaluate tumor response rates using modified-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepatocellular-carcinoma (HCC) treatment.Materials and Methods: We prospectively enrolled 24 HCC cirrhotic patients (21/3 M/F, mean age 66.3 years) to be treated with repeated DSMs-TACE procedures, performed at 4-6 week intervals on the basis of tumor response and patients tolerance. Clinical and biochemical evaluations were performed before and after each procedure. Treatment response was also assessed by Computed-tomography (CT) or Magnetic-resonance-imaging (MRI)-scan 4-6 weeks following each procedure.Results: In our experience, DSMs-TACE w as both safe and effective. A total of 53 DSMs-TACE procedures were performed (2.2 per patient). No procedure-related death was observed. Complete Response (CR) was observed in 5/24 (20.8%), 4/17 (23.5%) and 5/12 (41.6%) patients after the first, second and third procedure, respectively. At the end of each treatment, all patients experienced at least a partial response. At the end of the repeated procedures, no differences between mono-or bi-lobar disease were observed in patients with CR (64.2% vs 50%; p=ns). In most cases, treatment discontinuation was due to worsening liver function.Conclusion: DSMs-TACE is a valid, well-tolerated alternative treatment to Lipiodol-TACE or DEB-TACE, as it has demonstrated to achieve a relatively high percentage of complete tumor necrosis. CR rates were similar between patients with mono-or bi-lobar disease indicating the possibility of carrying-out repeated procedure in a safe and effective way in both types of patients.

Orlacchio, A., Chegai, F., Francioso, S., Merolla, S., Monti, S., Angelico, M., et al. (2018). Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma: A prospective pilot study. CURRENT MEDICAL IMAGING REVIEWS, 14(4), 637-645 [10.2174/1573405613666170616123657].

Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma: A prospective pilot study

Orlacchio A.;Chegai F.;Francioso S.;Monti S.;Angelico M.;Tisone G.;
2018-01-01

Abstract

Objective: The aims of this study were to: a) evaluate tumor response rates using modified-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepatocellular-carcinoma (HCC) treatment.Materials and Methods: We prospectively enrolled 24 HCC cirrhotic patients (21/3 M/F, mean age 66.3 years) to be treated with repeated DSMs-TACE procedures, performed at 4-6 week intervals on the basis of tumor response and patients tolerance. Clinical and biochemical evaluations were performed before and after each procedure. Treatment response was also assessed by Computed-tomography (CT) or Magnetic-resonance-imaging (MRI)-scan 4-6 weeks following each procedure.Results: In our experience, DSMs-TACE w as both safe and effective. A total of 53 DSMs-TACE procedures were performed (2.2 per patient). No procedure-related death was observed. Complete Response (CR) was observed in 5/24 (20.8%), 4/17 (23.5%) and 5/12 (41.6%) patients after the first, second and third procedure, respectively. At the end of each treatment, all patients experienced at least a partial response. At the end of the repeated procedures, no differences between mono-or bi-lobar disease were observed in patients with CR (64.2% vs 50%; p=ns). In most cases, treatment discontinuation was due to worsening liver function.Conclusion: DSMs-TACE is a valid, well-tolerated alternative treatment to Lipiodol-TACE or DEB-TACE, as it has demonstrated to achieve a relatively high percentage of complete tumor necrosis. CR rates were similar between patients with mono-or bi-lobar disease indicating the possibility of carrying-out repeated procedure in a safe and effective way in both types of patients.
2018
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/05 - PATOLOGIA CLINICA
English
HCC cirrhotic patients; Hepatocellular carcinoma; degradable starch microspheres; locoregional therapies; recurrence-free survival; transcatheter arterial chemoembolization
Orlacchio, A., Chegai, F., Francioso, S., Merolla, S., Monti, S., Angelico, M., et al. (2018). Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma: A prospective pilot study. CURRENT MEDICAL IMAGING REVIEWS, 14(4), 637-645 [10.2174/1573405613666170616123657].
Orlacchio, A; Chegai, F; Francioso, S; Merolla, S; Monti, S; Angelico, M; Tisone, G; Mannelli, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/246441
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