Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comp
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INTERVENTIONAL RADIOLOGY
Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comparing two types of drug‑eluting beads Janek Grumme1 · Thomas Werncke1 · Timo C. Meine1 · Lena S. Becker1 · Roman Kloeckner2 · Sabine K. Maschke1 · Martha M. Kirstein3 · Arndt Vogel3 · Frank K. Wacker1 · Bernhard C. Meyer1 · Jan B. Hinrichs1 · Thomas Rodt1,4
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose To compare two different types of drug-eluting microspheres with regard to impact on HRQoL after first TACE, tumour response, peri-procedural complications, adverse events and 1-year survival in patients suffering from unresectable hepatocellular carcinoma (HCC). Methods HRQoL was prospectively assessed with validated questionnaires (EORTC QLQ-C30 and -HCC18) before and 2 weeks after treatment with their first drug-eluting beads (DEB-)TACE with either acrylamido-polyvinylalcohol-AMPS hydrogel microspheres (groupDCB; 20 patients) or polyvinyl alcohol-co-acrylic acid microspheres (groupHS; 16 patients). Baseline characteristics, peri-procedural complications, treatment-related adverse events and 1-year survival were compared between both types of microspheres. Treatment response and objective response rates (ORR) were analysed using established tumour response criteria. Subgroup analysis for pooled groups with small (groupSMALL; 21 patients) versus large particles (groupLARGE; 15 patients) was performed. Results At baseline, there were no significant differences between the treated microsphere groups. No significant differences were found in absolute HRQoL changes after first DEB-TACE between the different types of microspheres. Response rates and survival were comparable between the investigated microsphere groups. For groupSMALL, we found a significant difference in post-interventional deterioration of physical function (− 19.4%) compared to g roupLARGE (− 8%; p = 0.025). Tumour response and ORR according to mRECIST were significantly higher in groupSMALL (p = 0.008; p = 0.009). Conclusion DEB-TACE is generally well tolerated and effective, with comparable changes in HRQoL for both types of drug-eluting microspheres. Tumour response is better with small microspheres. A relevant deterioration of physical function underlines that an aggressive TACE using small beads should be well deliberated. Keywords Hepatocellular carcinoma · Transarterial chemoembolization · Palliative therapy · Quality of life · HRQLQC30/-HCC18 · EORTC Abbreviations AFP Alpha-fetoprotein AST Aspartate aminotransferase ALBI Albumin-Bilirubin Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00261-019-02349-w) contains supplementary material, which is available to authorized users. Jan B. Hinrichs and Thomas Rodt have contributed equally to this work. * Jan B. Hinrichs hinrichs.jan@mh‑hannover.de Extended author information available on the last page of the article
ALT Alanine aminotransferase BCL
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