title: Transarterial chemoembolization for hepatocellular carcinoma with a new generation of beads: clinical-radiological outcomes and safety profile.
abstract: OBJECTIVE
  To evaluate the short-term safety and efficacy of the new generation of 70-150 µm drug-eluting beads (M1 DEB) in patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) as a primary therapy or as a bridge to liver transplantation (LT).
  
  
  METHODS
  Forty-five consecutive patients underwent TACE with M1 DEB loaded with doxorubicin (DEBDOX/M1). Clinical data were recorded at 12, 24, and 48 h, 7 and 30 days after treatment. Response was assessed by computed tomographic scan according to the modified response evaluation criteria in solid tumors criteria, and a second DEBDOX/M1 TACE was scheduled within 6 weeks in case of a noncomplete response.
  
  
  RESULTS
  All patients had well-compensated cirrhosis (97.7 % Child A, 44.4 % hepatitis C virus, median age 61 years). Twenty patients (44.4 %) had Barcelona Clinic for Liver Cancer class B disease; the median number of nodules and their sum of diameters were 2 (range 1-6) and 43 mm (range 10-190), respectively. The mean number of TACE procedures per patient was 1.4. Objective response rate (complete + partial response) was 77.7 % with a median time to best response of 3 months (95 % confidence interval 2-4). In 13 patients, DEBDOX/M1 TACE served as a bridge/downstaging to LT/surgery. Pathology showed that more than 90 % necrosis was achieved in 10 of 28 nodules. DEBDOX/M1 TACE was well tolerated, and the grade 3/4 adverse event rate was low (1 of 65 procedures).
  
  
  CONCLUSIONS
  DEBDOX/M1 TACE is an effective procedure with a favorable safety profile and promising results in terms of objective response rate, tumor downstaging, and necrosis.
authors.affiliation: Department of Radiology, Fondazione Istituto Tumori, via Venezian 1, 20133, Milan, Italy, carlo.spreafico@istitutotumori.mi.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Spreafico
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cascella
authors.forename: Antonio
authors.initials: A
authors.lastname: Facciorusso
authors.forename: Carlo
authors.initials: C
authors.lastname: Sposito
authors.forename: Lanocita
authors.initials: L
authors.lastname: Rodolfo
authors.forename: Carlo
authors.initials: C
authors.lastname: Morosi
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Civelli
authors.forename: Marta
authors.initials: M
authors.lastname: Vaiani
authors.forename: Sherrie
authors.initials: S
authors.lastname: Bhoori
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pellegrinelli
authors.forename: Alfonso
authors.initials: A
authors.lastname: Marchianò
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mazzaferro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007479:Iopamidol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D004317:Doxorubicin; D007479:Iopamidol