title: Single-center comparison of three chemoembolization regimens for hepatocellular carcinoma.
abstract: OBJECTIVE
  Transarterial chemoembolization regimens for hepatocellular carcinoma (HCC) vary, without a gold-standard method. The present study was performed to evaluate outcomes in patients with HCC treated with doxorubicin/ethiodized oil (DE), cisplatin/doxorubicin/mitomycin-c/ethiodized oil (CDM), or doxorubicin drug-eluting beads (DEBs).
  
  
  METHODS
  Patients received the same regimen at all visits, without crossover. Groups were compared based on Child-Pugh disease status, tumor/node/metastasis stage, and Barcelona Clinic Liver Cancer stage. Imaging outcomes were assessed based on modified Response Evaluation Criteria in Solid Tumors to calculate tumor response (ie, sum of complete and partial response), progressive disease (PD), and time to progression (TTP).
  
  
  RESULTS
  A total of 228 infusions were performed in 122 patients: 59 with DE, 30 with CDM, and 33 with DEBs. The groups had similar Child-Pugh status (P = .45), tumor/node/metastasis stages (P = .5), and Barcelona Clinic Liver Cancer scores (P = .22). Follow-up duration was similar among groups (P = .24). Patients treated with DE underwent significantly more treatments (2.3 ± 1.4) than those treated with CDM (1.6 ± 0.7; P = .004) or DEBs (1.4 ± 0.6; P<.0001). Compared with DE (51%), tumor response was significantly more common with CDM (84%; P = .003) or DEBs (82%; P = .004). PD was significantly more likely with DE (37%) than with CDM (13%; P = .02) or DEBs (9%; P = .004). TTP was similar between groups (P = .07). CDM and DEBs were similar in regard to disease progression (P = .6) and response (P = .83).
  
  
  CONCLUSIONS
  During a similar follow-up period, patients treated with CDM or DEB chemoembolization showed a significantly higher response rate and a lower incidence of tumor progression, with fewer required treatment sessions, than those treated with DE chemoembolization.
authors.affiliation: Division of Interventional Radiology/Department of Radiology, Thomas Jefferson University, 132 S 10th St, Suite 766, Main Building, Philadelphia, PA 19107, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Petruzzi
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Frangos
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Fenkel
authors.forename: Steven K
authors.initials: SK
authors.lastname: Herrine
authors.forename: Hie-Won
authors.initials: HW
authors.lastname: Hann
authors.forename: Simona
authors.initials: S
authors.lastname: Rossi
authors.forename: Ernest L
authors.initials: EL
authors.lastname: Rosato
authors.forename: David J
authors.initials: DJ
authors.lastname: Eschelman
authors.forename: Carin F
authors.initials: CF
authors.lastname: Gonsalves
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000706:statistics & numerical data*; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin; D004317:Doxorubicin; D002945:Cisplatin