title: Transarterial chemoembolization is a safe treatment for unresectable hepatic malignancies.
abstract: Acute liver failure has been reported as a frequent complication of transarterial chemoembolization (TACE). We prospectively evaluated the adverse effects and biochemical changes of TACE. From 10/95 to 9/96, 35 patients with hepatic malignancies were evaluated for TACE. Fifteen patients (9 male and 6 female) received 23 treatments. Ten of 15 patients had hepatocellular carcinoma, and 5 had metastatic tumors. Treatment exclusion criteria included advanced liver disease, hepatic vascular thrombosis, and severe comorbidity. TACE consisted of intra-arterial infusion of a mixture of doxorubicin, cisplatin, and mitomycin followed by embolization. Clinical symptoms and laboratory studies were monitored following treatment. Technical success was achieved in all patients. Adverse symptoms were transient, and most resolved within 1 week. Changes in hepatic, renal, and hematologic function were temporary and returned to pre-TACE levels by 1 month. None developed acute liver failure. The mean hospital stay was 3 days. Ten of 13 patients had a significant decrease in baseline tumor markers. The actual survival was 93 per cent with a median follow-up of 10 months. TACE can be performed safely in patients with hepatic tumors. The adverse effects can be anticipated and easily managed.
authors.affiliation: Comprehensive Liver Disease and Treatment Center, St. Vincent Medical Center, Los Angeles, CA 90057, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Lopez
authors.forename: S H
authors.initials: SH
authors.lastname: Pan
authors.forename: J F
authors.initials: JF
authors.lastname: Lois
authors.forename: M E
authors.initials: ME
authors.lastname: McMonigle
authors.forename: A L
authors.initials: AL
authors.lastname: Hoffman
authors.forename: L S
authors.initials: LS
authors.lastname: Sher
authors.forename: D
authors.initials: D
authors.lastname: Lugo
authors.forename: L
authors.initials: L
authors.lastname: Makowka
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000032:analysis; D002276:Carcinoid Tumor / Q000556:secondary / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007668:Kidney / Q000503:physiopathology; D007902:Length of Stay; D008099:Liver / Q000098:blood supply / Q000503:physiopathology; D008107:Liver Diseases; D017114:Liver Failure, Acute / Q000209:etiology; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D018579:Patient Selection; D011446:Prospective Studies; D012074:Remission Induction; D012449:Safety; D015996:Survival Rate; D013927:Thrombosis
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D008937:Mitomycins; D004317:Doxorubicin; D002945:Cisplatin