Bland embolization in patients with unresectable hepatocellular carcinoma using precise, tightly size-calibrated, anti-inflammatory microparticles: First clinical experience and one-year follow-up

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Abstract

The purpose of this study is to report on the feasibility, local response, and 1-year clinical outcome of bland transarterial embolization (TAE) with 40- and 100-μm Embozene microspheres in patients affected by unresectable hepatocellular carcinoma (HCC). Up to January 2009, 53 patients underwent superselective TAE for a total of 74 lesions. Diagnosis of HCC was based on multidetector computed tomography (MDCT), α-fetoprotein, and biopsy. MDCT was performed 24 after treatment and repeated at 1 month, 3 months, and then every 6 months. Local efficacy was defined according to RECIST criteria. Technical success was always achieved. Local results at 1-month, 3- to 6-month, and 6- to 12-month follow-up were 62%, 37%, and 16%, respectively, for stable disease and 35%, 56%, and 51%, respectively, for partial response. Complete response (no evidence of lesion) has been observed only at late follow-up (three lesions; 7%). To date, 20 of 53 patients have had at least 1 year of followup, with an overall survival rate of 96%. Hepatic progressive disease (i.e., new nodules) was observed in 14 of 20 patients due to underlying liver disease. Minor complications were observed in four patients. A major complication occurred in one patient, who died unexpectedly 24 h after TAE due to pulmonary embolism of necrotic pathologic tissue and passage of particles through a disrupted hepatic vein. Local results as well as 1-year clinical outcome after TAE with Embozene microspheres are veryly encouraging, however, further studies, a larger patient population, and a longer follow-up are mandatory to assess the real clinical impact.

Original languageEnglish
Pages (from-to)552-559
Number of pages8
JournalCardioVascular and Interventional Radiology
Volume33
Issue number3
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Hepatocellular Carcinoma
Anti-Inflammatory Agents
Multidetector Computed Tomography
Microspheres
Fetal Proteins
Hepatic Veins
Pulmonary Embolism
Liver Diseases
Survival Rate
Biopsy
Liver
Population

Keywords

  • Chemoembolization
  • Embolization
  • Hepatocellular carcinoma
  • Microparticles

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{7ead292a01d044d590cc2fa74b284b4b,
title = "Bland embolization in patients with unresectable hepatocellular carcinoma using precise, tightly size-calibrated, anti-inflammatory microparticles: First clinical experience and one-year follow-up",
abstract = "The purpose of this study is to report on the feasibility, local response, and 1-year clinical outcome of bland transarterial embolization (TAE) with 40- and 100-μm Embozene microspheres in patients affected by unresectable hepatocellular carcinoma (HCC). Up to January 2009, 53 patients underwent superselective TAE for a total of 74 lesions. Diagnosis of HCC was based on multidetector computed tomography (MDCT), α-fetoprotein, and biopsy. MDCT was performed 24 after treatment and repeated at 1 month, 3 months, and then every 6 months. Local efficacy was defined according to RECIST criteria. Technical success was always achieved. Local results at 1-month, 3- to 6-month, and 6- to 12-month follow-up were 62{\%}, 37{\%}, and 16{\%}, respectively, for stable disease and 35{\%}, 56{\%}, and 51{\%}, respectively, for partial response. Complete response (no evidence of lesion) has been observed only at late follow-up (three lesions; 7{\%}). To date, 20 of 53 patients have had at least 1 year of followup, with an overall survival rate of 96{\%}. Hepatic progressive disease (i.e., new nodules) was observed in 14 of 20 patients due to underlying liver disease. Minor complications were observed in four patients. A major complication occurred in one patient, who died unexpectedly 24 h after TAE due to pulmonary embolism of necrotic pathologic tissue and passage of particles through a disrupted hepatic vein. Local results as well as 1-year clinical outcome after TAE with Embozene microspheres are veryly encouraging, however, further studies, a larger patient population, and a longer follow-up are mandatory to assess the real clinical impact.",
keywords = "Chemoembolization, Embolization, Hepatocellular carcinoma, Microparticles",
author = "Guido Bonomo and Vittorio Pedicini and Lorenzo Monfardini and {Della Vigna}, Paolo and Dario Poretti and Gianluigi Orgera and Franco Orsi",
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T1 - Bland embolization in patients with unresectable hepatocellular carcinoma using precise, tightly size-calibrated, anti-inflammatory microparticles

T2 - First clinical experience and one-year follow-up

AU - Bonomo, Guido

AU - Pedicini, Vittorio

AU - Monfardini, Lorenzo

AU - Della Vigna, Paolo

AU - Poretti, Dario

AU - Orgera, Gianluigi

AU - Orsi, Franco

PY - 2010/6

Y1 - 2010/6

N2 - The purpose of this study is to report on the feasibility, local response, and 1-year clinical outcome of bland transarterial embolization (TAE) with 40- and 100-μm Embozene microspheres in patients affected by unresectable hepatocellular carcinoma (HCC). Up to January 2009, 53 patients underwent superselective TAE for a total of 74 lesions. Diagnosis of HCC was based on multidetector computed tomography (MDCT), α-fetoprotein, and biopsy. MDCT was performed 24 after treatment and repeated at 1 month, 3 months, and then every 6 months. Local efficacy was defined according to RECIST criteria. Technical success was always achieved. Local results at 1-month, 3- to 6-month, and 6- to 12-month follow-up were 62%, 37%, and 16%, respectively, for stable disease and 35%, 56%, and 51%, respectively, for partial response. Complete response (no evidence of lesion) has been observed only at late follow-up (three lesions; 7%). To date, 20 of 53 patients have had at least 1 year of followup, with an overall survival rate of 96%. Hepatic progressive disease (i.e., new nodules) was observed in 14 of 20 patients due to underlying liver disease. Minor complications were observed in four patients. A major complication occurred in one patient, who died unexpectedly 24 h after TAE due to pulmonary embolism of necrotic pathologic tissue and passage of particles through a disrupted hepatic vein. Local results as well as 1-year clinical outcome after TAE with Embozene microspheres are veryly encouraging, however, further studies, a larger patient population, and a longer follow-up are mandatory to assess the real clinical impact.

AB - The purpose of this study is to report on the feasibility, local response, and 1-year clinical outcome of bland transarterial embolization (TAE) with 40- and 100-μm Embozene microspheres in patients affected by unresectable hepatocellular carcinoma (HCC). Up to January 2009, 53 patients underwent superselective TAE for a total of 74 lesions. Diagnosis of HCC was based on multidetector computed tomography (MDCT), α-fetoprotein, and biopsy. MDCT was performed 24 after treatment and repeated at 1 month, 3 months, and then every 6 months. Local efficacy was defined according to RECIST criteria. Technical success was always achieved. Local results at 1-month, 3- to 6-month, and 6- to 12-month follow-up were 62%, 37%, and 16%, respectively, for stable disease and 35%, 56%, and 51%, respectively, for partial response. Complete response (no evidence of lesion) has been observed only at late follow-up (three lesions; 7%). To date, 20 of 53 patients have had at least 1 year of followup, with an overall survival rate of 96%. Hepatic progressive disease (i.e., new nodules) was observed in 14 of 20 patients due to underlying liver disease. Minor complications were observed in four patients. A major complication occurred in one patient, who died unexpectedly 24 h after TAE due to pulmonary embolism of necrotic pathologic tissue and passage of particles through a disrupted hepatic vein. Local results as well as 1-year clinical outcome after TAE with Embozene microspheres are veryly encouraging, however, further studies, a larger patient population, and a longer follow-up are mandatory to assess the real clinical impact.

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KW - Hepatocellular carcinoma

KW - Microparticles

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