Application of DC Beads in Hepatocellular Carcinoma: Clinical and Radiological Results of a Drug Delivery Device for Transcatheter Superselective Arterial Embolization

作者：Sadick Maliha^*; Haas Stephan; Loehr Matthias; Elshwi Mohammad; Singer Manfred V; Brade Joachim; Schoenberg Stefan O; Diehl Steffen J

来源：Onkologie, 2010, 33(1-2): 31-37.

DOI：10.1159/000264620

• Hepatocellular carcinoma
• Transarterial chemoembolization
• Particles
• Doxorubicin
• Drug-eluting beads
• Tumor necrosis

Aim: Application of a drug delivery device for transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Clinical and radiological treatment assessment. Patients and Methods: 24 patients with liver cirrhosis and uni- or multifocal HCC underwent TACE with doxorubicin beads (DC Bead (TM)). The underlying cause of liver cirrhosis was hepatitis (A: n = 7; B: n = 10) or alcohol consumption (n = 7). Patients presented with Child Pugh stage A (n = 15) and B (n = 9). The mean intrahepatic tumor size, considering the sum of diameters of all lesions treated, was 3.83 cm (+/- 2.4). Liver function and hematological parameters were documented before and after each TACE. Magnetic resonance imaging (MRI) was performed before and 4 weeks after TACE. The T1-w 3D volume-interpolated breathhold exam (VIBE) sequence was applied for evaluation of the therapy response. Results: 24 patients received a total number of 69 TACE treatments with DC beads (mean dose 160 mg). The elevation of liver function parameters after treatment did not affect the patients' clinical condition. The T1-w VIBE sequence proved very valuable for assessment of the intrahepatic tumor spread. Post-contrast images enabled delineation of the viable HCC lesions, hence facilitating the selective transcatheter approach. The tumor marker a-fetoprotein (AFP), available in 19/24 patients, dropped from 347.5 to 299.5 ng/ml, without being a reliable predictor of treatment response. A decrease of tumor size after TACE from 3.83 (+/- 2.40) to 3.01 cm (+/- 2.67; p < 0.0001) was evident on the T1w-VIBE sequences. The mean follow-up period was 30 months. At the time of data analysis, 10 (42%) out of 14 patients were alive. Conclusion: TACE with DC beads in HCC offers a safe and efficient treatment resulting in tumor response within a very short time.

• 出版日期2010
• 单位河北医科大学