Elena Bozzi MD, Presenter: Nothing to Disclose

Irene Bargellini MD, Abstract Co-Author: Nothing to Disclose

Rodolfo Sacco, Abstract Co-Author: Nothing to Disclose

Pasquale Petruzzi, Abstract Co-Author: Nothing to Disclose

Barbara Ginanni, Abstract Co-Author: Nothing to Disclose

Roberto Cioni MD, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

To prospectively compare conventional chemoembolization (cTACE) and Doxorubicin Eluting Bead (DEB)-TACE in cirrhotic patients with hepatocellular carcinoma (HCC).

From January 2006 to May 2009, 67 patients (45 males, mean age 70 years) with unresectable HCC (1-5 nodules, mean diameter 41.6±23.2 mm) were treated either with cTACE or DEB-TACE. Patients groups were comparable in terms of clinical parameters, tumor extension and doxorubicin dose. Primary endpoints were safety, liver toxicity and 1-month tumor response, according to amended RECIST criteria. Secondary endpoints were: (a) time to recurrence and local recurrence; (b) time to radiological progression; (c) survival.

Thirty-four patients received cTACE, whereas 33 subjects underwent DEB-TACE. Mean follow-up was 816±361 days. Two (2.9%) periprocedural major complications occurred, solved by medical therapy. A significant increase in ALT levels 24h after treatment was reported (pre-procedure: 67±53 IU; 24 hours: 161±167 IU; P<.0001); this increase was significantly higher after cTACE compared to DEB-TACE (P=.007). At 1-month CT follow-up, complete and partial tumour response rates were 70.6% and 29.4%, respectively, in the cTACE group, and 51.5% and 48.5%, respectively, in DEB-TACE arm (P=.1). Overall, median expected time to recurrence and local recurrence was 390 and 364 days, respectively, with comparable results among treatment arms (P=.99 and P=.46). Radiological disease progression occurred in 12 patients (17.9%) with mean expected time of 741 days; no significant difference was observed between cTACE and DEB-TACE. The 24-months cumulative survival rate was 83.6% and 86.8%, after cTACE and DEB-TACE, respectively (P=.96).

Both cTACE and DEB-TACE are safe treatments, with limited impact on liver function and favourable long-term clinical outcomes.

 DEB-TACE may play an important and alternative role for the treatment of hepatocellular carcinoma.

Bozzi, E, Bargellini, I, Sacco, R, Petruzzi, P, Ginanni, B, Cioni, R, Bartolozzi, C, Conventional versus Doxorubicin-eluting Bead Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005193.html