title: Impact of Different Embolic Agents for Transarterial Chemoembolization (TACE) Procedures on Systemic Vascular Endothelial Growth Factor (VEGF) Levels.
abstract: Background and Aims:Intermediate stage hepatocellular carcinoma (HCC) can be treated by transarterial chemoembolization (TACE). However, there appear to be side effects, such as induction of proangiogenic factors, e.g. vascular endothelial growth factor (VEGF), which have been shown to be associated with a poor prognosis. This prospective study was designed to compare serum VEGF level response after TACE with different embolic agents in patients with HCC.Methods:Patients were assigned to one of three different TACE regimens: degradable starch microspheres (DSM) TACE, drug-eluting bead (DEBDOX) TACE or Lipiodol TACE (cTACE). All patients received 50 mg doxorubicin/m2body surface area (BSA) during TACE. Serum VEGF levels were assessed before TACE treatment, 24 h post-treatment and 4 weeks later.Results:Twenty-two patients with 30 TACE treatments were enrolled. Compared to baseline VEGF levels, a marked increase was observed for 24 h post-TACE (164% of baseline level) and during the 4-week follow-up (170% of baseline level) only for the cTACE arm (p< 0.05). In contrast, the increase of serum VEGF levels were only 114% and 123% for DEBDOX and 121% and 124% for DSM, respectively.Conclusions:Conventional TACE using Lipiodol shows marked increase in blood levels of the proangiogenic factor VEGF, while DEBDOX and DSM TACE induce only a moderate VEGF response.
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schicho
authors.affiliation: Friedrich-Alexander University Erlangen-Nürnberg, Institute of Biochemistry (Emil-Fischer Zentrum), Erlangen, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Hellerbrand
authors.affiliation: Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Krüger
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Lukas P
authors.initials: LP
authors.lastname: Beyer
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Wohlgemuth
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Niessen
authors.affiliation: Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Hohenstein
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany.
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiggermann
keywords: Angiogenesis; Embolic agents; Hepatocellular carcinoma; Transarterial chemoembolization; Vascular endothelial growth factor