Drug-Eluting Beads Loaded With Doxorubicin (DEBDOX) Chemoembolisation Before Liver Transplantation for Hepatocellular Carcinoma: An Imaging/Histologic Correlation Study

作者：Pauwels Xavier; Azahaf Mustapha; Lassailly Guillaume; Sergent Geraldine; Buob David; Truant Stephanie; Boleslawski Emmanuel; Louvet Alexandre; Gnemmi Vivianne; Canva Valerie; Mathurin Philippe; Pruvot Francois Rene; Leteurtre Emmanuelle; Ernst Olivier; Dharancy Sebastien^*

来源：CardioVascular and Interventional Radiology, 2015, 38(3): 685-692.

DOI：10.1007/s00270-014-0967-1

• Hepatocellular carcinoma
• Liver transplantation
• Transarterial
• Chemoembolisation
• Doxorubicin-eluting bead
• Tumor histology
• Treatment response

Most transplant centers use chemoembolisation as locoregional bridge therapy for hepatocellular carcinoma (HCC) before liver transplantation (LT). Chemoembolisation using beads loaded with doxorubicin (DEBDOX) is a promising technique that enables delivery of a large quantity of drugs against HCC. We sought to assess the imaging-histologic correlation after DEBDOX chemoembolisation.
All consecutive patients who had undergone DEBDOX chemoembolisation before receiving liver graft for HCC were included. Tumour response was evaluated according to Response Evaluation Criteria in Solid Tumours (RECIST) and modified RECIST (mRECIST) criteria. The result of final imaging made before LT was correlated with histological data to predict tumour necrosis.
Twenty-eight patients underwent 43 DEBDOX procedures for 45 HCC. Therapy had a significant effect as shown by a decrease in the mean size of the largest nodule (p = 0.02) and the sum of viable part of tumour sizes according to mRECIST criteria (p < 0.001). An objective response using mRECIST criteria was significantly correlated with mean tumour necrosis a parts per thousand yen90 % (p = 0.03). A complete response using mRECIST criteria enabled accurate prediction of complete tumour necrosis (p = 0.01). Correlations using RECIST criteria were not significant.
Our data confirm the potential benefit of DEBDOX chemoembolisation as bridge therapy before LT, and they provide a rational basis for new studies focusing on recurrence-free survival after LT. Radiologic evaluation according to mRECIST criteria enables accurate prediction of tumour necrosis, whereas RECIST criteria do not.

• 出版日期2015-6