1Khalid Mahmoud,2Husameddin El Khudari, 2Husameddin El Khudari, 1Ahmed Kamel Abdel Aal
1University of Texas at Houston, 2University of Alabama at Birmingham
According to the limited information in Computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of sub-centimeter pulmonary nodules with radiation burden to the patients and operator The aim of the study is to evaluate the effectiveness and safety of 75µm drug-eluting-embolic (DEE) in transarterial-chemoembolization (TACE) for patients with advanced Barcelona Clinic for Liver Cancer stage-C (BCLC-C) hepatocellular carcinoma (HCC).
Material(s) and Method(s):
The medical records of patients with advanced-stage (BCLC-C) HCC who had DEE-TACE using 75µm-DEEs loaded with Doxorubicin as their first treatment for unresectable HCC between November-2013 and March-2021 were retrospectively reviewed. Patients who had prior therapy for HCC were excluded. Tumor response and the toxicity profile were assessed.
Mean age of patieThe study included 46-patients with a mean age of 65.3-years (SD=9.5 years). Child-Pugh (CP) A and B patients constituted 71.7% and 28.3% of the patients respectively. The mean size of the index tumors was 5.34cm (SD=2.9cm), with 16 (34.8%) patients having central tumors around the porta-hepatis region. Portal vein (PV) invasion was seen in 9 (19.6%) patients. Twenty-one (45.6%) patients had a single hepatic lesion. At first imaging follow up, complete response, objective response and disease control was seen in 21.5%, 62% and 81% respectively. The median progression-free survival was 7.2-months. The overall-survival was 18.3-months (22.4-months for responders versus 8.7-months for non-responders, p= 0.002). The 6, 12 and 24-months survival were 61.9%, 34.76% and 13.02% respectively. Grade-3 and 4 clinical adverse events were seen in 8.8%, and grade-4 hepatobiliary injuries were seen in 2.2% of patients. There were no grade-5 adverse events reported.
Although advanced-stage patients are usually offered systemic chemotherapy, TACE using 75µm-DEE is safe and efficacious and may be considered as an adjuvant or sole therapy.