Bland embolization of hepatocellular carcinoma using superabsorbent polymer microspheres.
The purpose of this study was to investigate the clinical outcomes of bland embolization using superabsorbent polymer microspheres (SAP-TAE) as an initial therapeutic option for previously untreated hepatocellular carcinoma (HCC) ineligible for resection or ablation. Fifty-nine patients with previously untreated HCC unamenable to surgery or ablation underwent bland embolization using 100- to 200-mum reconstituted SAP particles (SAP-TAE) as the initial treatment. SAP-TAE was repeated as needed based on tumor response but was switched to chemoembolization when necessary to control residual or progressive tumor. Early tumor response was assessed by contrast-enhanced CT according to RECIST and EASL criteria 1 month after the initial SAP-TAE. The overall survival was calculated using the Kaplan-Meier method. The overall mean follow-up period was 30.6 months (range, 7-59 months). A total of 121 sessions of SAP-TAE were performed, with 1-5 sessions per patient (mean, 2.1 sessions). The mean period of repeated SAP-TAE was 15.6 months (range, 1-51 months), and it exceeded 1 and 2 years in 32 (54%) and 15 (25%) patients, respectively. Thirteen (22%) patients underwent repeated SAP-TAE alone, and the remaining 46 (78%) patients underwent subsequent chemoembolization. No major complication was observed and postembolization syndrome was minimal after SAP-TAE in all patients. Response rate was 14% and 66% by RECIST and EASL criteria, respectively. Overall survival rates were 100% and 83% at 1 and 2 years, respectively, and median survival time was 30 months. In conclusion, SAP-TAE was a safe and repeatable option as the induction therapy for HCC unamenable to surgery or ablation, despite the high incidence of converting to TACE during the total course.
Osuga
Keigo
K
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka Suita, Osaka 565-0871, Japan. osuga@radiol.med.osaka-u.ac.jp
Hori
Shinichi
S
Hiraishi
Kumiko
K
Sugiura
Takashi
T
Hata
Yasuhiro
Y
Higashihara
Hiroki
H
Maeda
Noboru
N
Tomoda
Kaname
K
Nakamura
Hironobu
H
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007485:Ioxaglic Acid; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011108:Polymers; D015641:Radiography, Interventional; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media; D011108:Polymers; D007485:Ioxaglic Acid