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Increased Arterio-Portal Shunt Formation after Drug-Eluting Beads TACE for Hepatocellular Carcinoma.
- Source :
-
Oncology [Oncology] 2020; Vol. 98 (8), pp. 558-565. Date of Electronic Publication: 2020 May 18. - Publication Year :
- 2020
-
Abstract
- Background and Aims: Conventional transcatheter arterial chemoembolization (C-TACE) and drug-eluting bead (DEB)-based TACE are current treatments for hepatocellular carcinoma (HCC). We compared the therapeutic efficacies and adverse events of these methods in a single-center retrospective cohort study.<br />Methods: We enrolled 174 patients treated between January 2010 and October 2016; 98 and 76 underwent C-TACE and DEB-TACE, respectively, with 76 and 22 of the former group and 49 and 27 of the latter group classified as Child-Pugh class A and B, respectively. Therapeutic outcomes, progression-free survival (PFS), and adverse events were evaluated.<br />Results: The PFS rates in the C-TACE and DEB-TACE groups were 8.1 and 6.1 months, respectively (p = 0.79). The response and disease control rates were 64 and 71% in C-TACE patients and 69 and 78% in DEB-TACE patients, respectively (p = 0.25). Postprocedural pain, vomiting, and fever were more frequent following C-TACE than DEB-TACE (p < 0.001). In contrast, the incidences of bilomas and arterio-portal shunts were significantly higher following DEB-TACE (p < 0.001); the incident rates of arterio-portal shunt formation were 8.1 and 48.7% in patients undergoing C-TACE and DEB-TACE, respectively. Child-Pugh class A was significantly associated with arterio-portal shunt formation after DEB-TACE on multivariate analysis.<br />Conclusions: There were no significant differences in the therapeutic efficacies of C-TACE and DEB-TACE. However, the frequency of arterio-portal shunt formation was significantly higher in HCC patients with Child-Pugh class A undergoing DEB-TACE. Our findings imply that C-TACE should be selected for HCC patients with Child-Pugh class A and DEB-TACE should be chosen for those with Child-Pugh class B.<br /> (© 2020 S. Karger AG, Basel.)
- Subjects :
- Aged
Aged, 80 and over
Antibiotics, Antineoplastic administration & dosage
Catheterization methods
Epirubicin administration & dosage
Female
Humans
Male
Middle Aged
Progression-Free Survival
Retrospective Studies
Arteriovenous Fistula etiology
Carcinoma, Hepatocellular therapy
Chemoembolization, Therapeutic adverse effects
Chemoembolization, Therapeutic methods
Drug Delivery Systems adverse effects
Drug Delivery Systems methods
Liver Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1423-0232
- Volume :
- 98
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32422633
- Full Text :
- https://doi.org/10.1159/000507262