Francesco Somma MD, Presenter: Nothing to Disclose

Roberto D'Angelo MD, Abstract Co-Author: Nothing to Disclose

Gianluca Gatta, Abstract Co-Author: Nothing to Disclose

Roberto Grassi, Abstract Co-Author: Nothing to Disclose

Francesco Fiore MD, Abstract Co-Author: Nothing to Disclose

Hepatocellular carcinoma (HCC) is nowadays the third leading cause of cancer deaths worldwide. A variety of treatment modalities have been reported including resection, chemoembolisation, external irradiation, radiofrequency or percutaneous ethanol ablation. Our aim is to retrospectively evaluate the efficacy and safety of transarterial embolisation of intermediate HCC, using a mixture 1:1 of Ethanol and Lipiodol, that we named Trans-Arterial EThanol Embolisation (TAETE), compared with conventional Trans-Arterial Chemo-Embolisation (cTACE)

87 patients (37.93% male; 62.07% female; range of age 36-86 years) with documented hepatic lesions of 1.4 to 5.4 cm in size were elected to TAETE (Ethanol and Lipiodol, 1:1) or cTACE (Epirubicin and Lipiodol), through a super-selective catheterization with direct injection in the tumor-feeding arteries. Both procedures were followed by the intrarterial administration of embolizing agents (70-150µ).  

TAETE and cTACE therapies were performed in 45 and 42 patients, respectively. Thirty days after the procedure, a Multislice Computed Tomography (MSCT) showed in all patients at least partial response according to RECIST1.1 and EASL criteria, while in 51/87 (58.62%) patients a complete resolution was observed, with no statistically significant difference between the two groups. On the contrary, there was significant difference in the overall incidence of side-effects, such as in the occurrence of post-embolisation syndrome (p<0.001).

Compared to cTACE, TAETE showed to be more effective in the size-reduction of tumoral mass with similar anti-tumor effects at thirty-day MSCT control and better toxicity profile, which makes it extremely useful in patients with more than one lesion or in case of relapse.   

Considering the onset of adverse events according to CTCAE version 4.0 (2009), TAETE is less invasive than cTATE (p=0.019, chi2-test with Yates-correction), showing no significative difference in the radiological tumor response according to mRECIST and EASL (p=0.958, chi2 test). TAETE could be used in elderly HCC patients or in case of multiple treatments  

Somma, F, D'Angelo, R, Gatta, G, Grassi, R, Fiore, F, Trans-Arterial EThanol Embolisation (TAETE) vs Conventional Chemoembolisation (cTACE) in the Treatment of BCLC Intermediate Stage HCC.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019121.html