title: Transcatheter arterial chemotherapy with and without embolization in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  This study compared the antitumor effect, adverse effects and survival between transcatheter arterial embolization (TAE) and transcatheter arterial infusion chemotherapy (TAI) in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  The study population consisted of 168 consecutive patients with advanced HCC treated with transcatheter arterial treatments using cisplatin suspended in lipiodol. Among these, 74 patients were treated with TAE, and the remaining 94 patients were treated with TAI.
  
  
  RESULTS
  There were no significant differences in any baseline characteristics except hemoglobin, platelets, albumin, and glutamic pyruvic transaminase. Complete or partial tumor response was achieved in 54 patients (73%) in the TAE group and in 48 patients (51%) in the TAI group (p < 0.01). There were two treatment-related deaths caused by acute hepatic failure and acute renal failure in the TAE group. Nausea and deterioration of serum transaminase after TAE were significantly more severe than after TAI. Median survival time and survival rates at 5 years were 3.1 years and 25% in the TAE group, and 2.5 years and 18% in the TAI group (p = 0.37).
  
  
  CONCLUSIONS
  TAE has a higher antitumor effect than TAI, but does not significantly improve the survival of patients with HCC.
authors.affiliation: Third Department of Internal Medicine, Kumamoto University School of Medicine, Kumamoto, Japan. masikeda@ncc.go.jp
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Seishi
authors.initials: S
authors.lastname: Maeda
authors.forename: Junji
authors.initials: J
authors.lastname: Shibata
authors.forename: Ryushi
authors.initials: R
authors.lastname: Muta
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ashihara
authors.forename: Motohiko
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Fujiyama
authors.forename: Kimio
authors.initials: K
authors.lastname: Tomita
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D016461:Chemoembolization, Therapeutic; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007459:Iodized Oil; D002945:Cisplatin