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

Antonio Orlacchio, Fabrizio Chegai, Simona Francioso, Stefano Merolla, Serena Monti, Mario Angelico, Giuseppe Tisone, Lorenzo Mannelli

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: The aims of this study were to: a) evaluate tumor response rates using modi-fied-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepa-tocellular-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 was 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.

Original languageEnglish
Pages (from-to)637-645
Number of pages9
JournalCurrent Medical Imaging Reviews
Volume14
Issue number4
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hepatocellular Carcinoma
Prospective Studies
Carcinoma
Ethiodized Oil
Therapeutics
degradable starch microspheres
Neoplasms
Necrosis
Tomography
Magnetic Resonance Imaging
Safety
Liver

Keywords

  • Degradable starch microspheres
  • HCC cirrhotic patients
  • Hepatocellular carcinoma
  • Locoregional therapies
  • Recurrence-free survival
  • Transcatheter arterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma : A prospective pilot study. / Orlacchio, Antonio; Chegai, Fabrizio; Francioso, Simona; Merolla, Stefano; Monti, Serena; Angelico, Mario; Tisone, Giuseppe; Mannelli, Lorenzo.

In: Current Medical Imaging Reviews, Vol. 14, No. 4, 01.01.2018, p. 637-645.

Research output: Contribution to journalArticle

Orlacchio, Antonio ; Chegai, Fabrizio ; Francioso, Simona ; Merolla, Stefano ; Monti, Serena ; Angelico, Mario ; Tisone, Giuseppe ; Mannelli, Lorenzo. / Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma : A prospective pilot study. In: Current Medical Imaging Reviews. 2018 ; Vol. 14, No. 4. pp. 637-645.
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abstract = "Objective: The aims of this study were to: a) evaluate tumor response rates using modi-fied-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepa-tocellular-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 was 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.",
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T1 - Repeated transarterial chemoembolization with degradable starch microspheres (DSMs-TACE) of unresectable hepatocellular carcinoma

T2 - A prospective pilot study

AU - Orlacchio, Antonio

AU - Chegai, Fabrizio

AU - Francioso, Simona

AU - Merolla, Stefano

AU - Monti, Serena

AU - Angelico, Mario

AU - Tisone, Giuseppe

AU - Mannelli, Lorenzo

PY - 2018/1/1

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N2 - Objective: The aims of this study were to: a) evaluate tumor response rates using modi-fied-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepa-tocellular-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 was 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.

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KW - HCC cirrhotic patients

KW - Hepatocellular carcinoma

KW - Locoregional therapies

KW - Recurrence-free survival

KW - Transcatheter arterial chemoembolization

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