title: Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma: comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study.
abstract: Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group ( P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group ( P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group ( P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Seungsoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang-Hun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.affiliation: 2 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: 2 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D004998:Ethiodized Oil; D004317:Doxorubicin
keywords: Drug-eluting bead; doxorubicin; hepatic arterial damage; transarterial chemoembolization