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.
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
Keigo
K
Osuga
Shinichi
S
Hori
Kumiko
K
Hiraishi
Takashi
T
Sugiura
Yasuhiro
Y
Hata
Hiroki
H
Higashihara
Noboru
N
Maeda
Kaname
K
Tomoda
Hironobu
H
Nakamura
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