title: Efficacy of preoperative transcatheter arterial chemoembolization combined with systemic chemotherapy for treatment of unresectable hepatoblastoma in children.
abstract: OBJECTIVE
  The purpose of this study was to evaluate, retrospectively, the clinical efficacy of preoperative transcatheter arterial chemoembolization (TACE) combined with systemic chemotherapy for unresectable hepatoblastoma.
  
  
  METHODS
  Five boys and three girls (mean age 15.2 months) were treated with preoperative TACE combined with systemic chemotherapy for unresectable hepatoblastomas. Mean tumor diameter and mean alfa-fetoprotein (AFP) level were 11.8 cm and 549,386 ng/mL, respectively. Pretreatment, the extent of disease (PRETEXT) was: II, 1; III, 6; IV, 1. For all patients, preoperative systemic chemotherapy was administered before TACE. At each TACE, carboplatin and adriamycin mixed with iodized oil were infused into the feeding arteries. Tumor response and prognosis after treatment were evaluated.
  
  
  RESULTS
  TACE resulted in few Grade 1 adverse effects (AEs), without G3 or more AEs, according to CTACAE 3.0. Mean tumor shrinkage was 60.9%, and the mean AFP decrease from initial levels was 94.8%. In all cases TACE combined with systemic chemotherapy enabled subsequent safe and complete surgical resection. After a mean follow-up of 59 months, tumor-free survival was 75%.
  
  
  CONCLUSIONS
  Preoperative TACE combined with systemic chemotherapy was effective in inducing surgical resectability of unresectable hepatoblastoma.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, mahira@radiol.med.kyushu-u.ac.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Asayama
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Fujita
authors.forename: Kousei
authors.initials: K
authors.lastname: Ishigami
authors.forename: Tatsurou
authors.initials: T
authors.lastname: Tajiri
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D016190:Carboplatin / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D018197:Hepatoblastoma / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007223:Infant; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007459:Iodized Oil; D004317:Doxorubicin; D016190:Carboplatin