title: Comparison of two transarterial chemoembolization strategies for hepatocellular carcinoma.
abstract: OBJECTIVE
  This retrospective study aimed to compare the efficacy of and tolerance to two center-related conventional transarterial chemoembolization (TACE) strategies in the management of unresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  All HCC patients in whom TACE was initiated in the two centers from June 2008 to July 2011 were included. The TACE strategy performed in center 1 was "on demand" with selective injections of idarubicin, whereas the TACE strategy in center 2 was based "on scheduled" non-selective injections of epirubicin. Toxicity was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events v4.0.
  
  
  RESULTS
  One hundred and fifty HCC patients were included. Median time to treatment failure was significantly higher in center 1, 13.1 months vs. 7.9 months in center 2 (hazard ratio, 2.32; p<10-3 in multivariate analysis). Median overall survival was 21.1 months in center 1 vs. 18.4 months in center 2 (p=NS). The proportion of grade ≥ 3 adverse events and mean hospitalisation duration for the overall TACE treatment were significantly greater in center 2 than in center 1: 56% vs. 32% (p<0.01) and 14.2 ± 7.2 days vs. 10.3 ± 7.0 days (p<0.01), respectively.
  
  
  CONCLUSIONS
  Our results failed to show any significant survival differences between two center-related TACE strategies but showed a significantly smaller proportion of grade ≥ 3 adverse events and shorter hospitalisation for the overall treatment when the "on-demand" strategy was used.
authors.affiliation: Department of Pharmacy, University Hospital, Clermont-Ferrand, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Tavernier
authors.affiliation: Department of Pharmacy, University Hospital, Dijon, France EA 4184, Burgundy University, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Fagnoni
authors.affiliation: Department of Interventional Radiology, University Hospital, Clermont-Ferrand, France ISIT UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Chabrot
authors.affiliation: Department of Interventional Radiology, University Hospital, Dijon, France INSERM U866, Burgundy University, Dijon, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Guiu
authors.affiliation: Department of Pharmacy, University Hospital, Dijon, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Vadot
authors.affiliation: Department of Hospital Hygiene and Epidemiology, University Hospital, Dijon, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Aho
authors.affiliation: Department of Interventional Radiology, University Hospital, Clermont-Ferrand, France ISIT UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Boyer
authors.affiliation: ISIT UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France Department of Hepato-Gastroenterology, University Hospital, Clermont-Ferrand, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.affiliation: EA 4184, Burgundy University, Dijon, France Department of Hepato-Gastroenterology, University Hospital, Dijon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hillon
authors.affiliation: Department of Pharmacy, University Hospital, Clermont-Ferrand, France EA 4676 C-BIOSENSS, Auvergne University, Clermont-Ferrand, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Sautou
authors.affiliation: Department of Pharmacy, University Hospital, Dijon, France EA 4184, Burgundy University, Dijon, France mathieuboulin@yahoo.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Boulin
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D015251:Epirubicin / Q000627:therapeutic use; D004998:Ethiodized Oil / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D007261:Infusions, Intra-Arterial / Q000009:adverse effects / Q000379:methods*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D015251:Epirubicin; D004998:Ethiodized Oil; D015255:Idarubicin
keywords: Transarterial chemoembolization; efficacy; hepatocellular carcinoma; strategy; tolerance