Oily chemoembolization combined with degradable starch microspheres for HCC with cirrhosis.
OBJECTIVE
To assess efficacy of transcatheter arterial chemoembolization (TACE) combined with degradable starch microspheres (DSM) for patients with liver cirrhosis and hepatocellular carcinoma (HCC).


METHODS
Our studied population was 19 patients with unresectable HCC and liver dysfunction due to repeated TACE, in whom we were unable to selectively advance a microcatheter into the feeding arteries because of tortuous or complex feeding arteries to the HCC. To avoid embolization of an extended non-tumorous area, we conducted Lipiodol-TACE after DSM-embolization (TACE-DSM) of the tumor-free parenchyma. Embolization data and clinical parameters were prospectively assessed.


RESULTS
TACE-DSM was performed 21 times in the 19 patients, and the overall technical success rate was 81%. The TACE-DSM method did not induce severe liver dysfunction. A favorable response involving necrosis of more than 80% or 50% of the tumor was seen in 62% and 90% of cases, respectively. In the follow-up period (8 to 36 months), complete necrosis of the targeted tumors was observed in 26% of cases. The 2-year survival rates calculated as starting from the date of TACE-DSM therapy was 32.6%.


CONCLUSIONS
From these results we conclude that TACE-DSM therapy is useful for protecting liver function in patients with cirrhosis and unresectable HCC.
Murata
Satoru
S
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan. genji@nms.ac.jp
Tajima
Hiroyuki
H
Ichikawa
Kazuo
K
Onozawa
Shiro
S
Wang
Jian
J
Kumita
Shinichiro
S
Nomura
Kazuhiro
K
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage*; D015251:Epirubicin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000098:blood supply / Q000401:mortality / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010166:Palliative Care; D013213:Starch; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D015251:Epirubicin; D007459:Iodized Oil; D013213:Starch