Song, Myeong Jun; Park, Chung-Hwa; Kim, Jin Dong; Kim, Hee Yeon; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew; Chun, Ho Jong; Choi, Byung Gil; Lee, Hae Giu
European journal of gastroenterology & hepatology
2011Jun ; 23 ( 6 ) :521-7.
PMID : 21537127
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Song, Myeong Jun -
Park, Chung-Hwa -
Kim, Jin Dong -
Kim, Hee Yeon -
Bae, Si Hyun -
Choi, Jong Young -
Yoon, Seung Kew -
Chun, Ho Jong -
Choi, Byung Gil -
Lee, Hae Giu -
ABSTRACT
OBJECTIVE: Lipiodol transcatheter arterial chemoembolization (TACE) is widely used to treat hepatocellular carcinoma (HCC). Recently, a drug-eluting bead (DEB) has been developed to enhance drug delivery to the tumor and reduce its systemic availability. The purpose of this study was to compare the efficacy and safety of intra-arterial injection of DEB loaded with doxorubicin versus conventional, Lipiodol-based TACE regimens in Asian patients with HCC.
METHODS: The study was designed as a case-control, single-institution clinical trial. Twenty patients with HCC who received DEB loaded with 50 mg doxorubicin ('cases') were matched with 20 patients who had undergone conventional TACE ('controls'). The primary efficacy endpoint was tumor response at 1 month according to modified Response Evaluation Criteria in Solid Tumors. The primary safety endpoint was liver toxicity.
RESULTS: The rate of objective response by modified Response Evaluation Criteria in Solid Tumors was 85% (17 of 20 patients) in the DEB arm versus 30% (six of 20 patients) in the conventional TACE arm (P=0.001). Subgroup analyses conducted in patients with large (>5 cm) or multinodular tumor confirmed significantly higher objective response rates in patients receiving DEB as compared with those treated with conventional TACE (P=0.003 and P=0.005, respectively). At the dose of 50 mg doxorubicin, there was no statistically significant difference in liver toxicity between DEB and conventional TACE (P>0.05). CONCLUSION: In Asian patients with HCC, transcatheter treatment with DEB loaded with doxorubicin offers a distinct advantage in objective tumor response rate as compared with conventional, Lipiodol-based TACE regimens.
chemoembolization, drug-eluting bead, hepatocellular carcinoma
MESH
Aged, Antibiotics, Antineoplastic/*administration & dosage/adverse effects, *Asian Continental Ancestry Group/statistics & numerical data, Carcinoma, Hepatocellular/ethnology/pathology/*therapy, Case-Control Studies, Catheterization, Peripheral, *Chemoembolization, Therapeutic/adverse effects, Chi-Square Distribution, Doxorubicin/*administration & dosage/adverse effects, *Drug Carriers, Ethiodized Oil/*administration & dosage/adverse effects, Female, Hepatic Artery, Humans, Injections, Intra-Arterial, Liver Neoplasms/ethnology/pathology/*therapy, Male, Middle Aged, Neoplasm Staging, Republic of Korea, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Tumor Burden
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