Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: a pilot clinical study.
OBJECTIVE
Experimental studies have shown synergy between radiofrequency (RF) ablation and adjuvant chemotherapy in animal tumour models. We aimed to assess safety and efficacy of doxorubicin-eluting bead (DEB)-enhanced RF ablation in the treatment of human hepatocellular carcinoma (HCC).


METHODS
Twenty patients with single HCC ranging 3.3-7.0 cm (mean, 5.0 cm+/-1.4) showing evidence of residual viable tumour after standard RF ablation underwent intraarterial DEB administration (50-125 mg doxorubicin; mean, 60.2 mg+/-21.8). Follow-up period ranged 6-20 months (mean, 12 months+/-5).


RESULTS
No major complication occurred. No deterioration of liver function was observed. The volume of treatment-induced necrosis--as measured on imaging--increased from 48.1 cm3+/-35.7 after RF ablation to 75.5 cm3+/-52.4 after DEB administration, with an increase of 60.9%+/-39.0. The enhanced effect resulted in confirmed complete response (CR) of the target lesion in 12 (60%) of 20 patients. Incomplete response with persistence of <10% of initial tumour volume was observed in 6 (30%) of 20 patients, and local tumour progression in 2 (10%) of 20.


CONCLUSIONS
Intraarterial DEB administration substantially enhances the effect of RF ablation. DEB-enhanced RF ablation is safe and results in a high rate of CR in patients refractory to standard RF treatment.
Lencioni
Riccardo
R
Division of Diagnostic and Interventional Radiology, Department of Oncology and Radiology, Cisanello University Hospital - Building No. 9, Via Paradisa 2, IT-56124 Pisa, Italy. lencioni@med.unipi.it
Crocetti
Laura
L
Petruzzi
Pasquale
P
Vignali
Claudio
C
Bozzi
Elena
E
Della Pina
Clotilde
C
Bargellini
Irene
I
Cioni
Dania
D
Oliveri
Filippo
F
De Simone
Paolo
P
Bartolozzi
Carlo
C
Brunetto
Maurizia
M
Filipponi
Franco
F
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin