Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma

Hasmukh Prajapati, Renumathy Dhanasekaran, Bassel F. El-Rayes, John S. Kauh, Shishir K. Maithel, Zhengjia Chen, Hyun S. Kim

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Purpose: To investigate the safety and efficacy of transarterial chemoembolization using doxorubicin drug-eluting beads (DEBs) in patients with Barcelona Clinic Liver Cancer (BCLC) C stage hepatocellular carcinoma (HCC). Methods: Consecutive patients with initial staging of BCLC C HCC who received DEB transarterial chemoembolization over the last 5 years were studied. The study included 121 patients (mean age, 61.2 years old). Adverse events (AEs) after DEB transarterial chemoembolization were studied in detail and were recorded as per the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria. Survivals were analyzed according to parameters from the time of first DEB transarterial chemoembolization. Kaplan-Meier method by log-rank test and Cox proportional hazard model were used for survival analysis. Results: AEs occurred in 30.2% of patients. No AEs were greater than Common Terminology Criteria for Adverse Events grade III. Grade I and II AEs included nausea and vomiting in 7.8% of patients and abdominal pain in 23.8% of patients. Grade III AEs were noted in 1.06% of patients. There were no gastrointestinal or hepatic complications. There were no deaths within 30 days after DEB transarterial chemoembolization. The overall median survival was 13.5 months. Among the Child-Pugh class A patients, those without PVT and metastasis (28.9%) had better survival when treated with DEB transarterial chemoembolization than those with PVT and metastases (9.9%) (18.8 mo versus 4.4 mo, P =.001). Ascites, performance status, Okuda stage HCC, serum alpha fetoprotein levels, and etiologic factor for chronic liver disease predicted survival. Conclusions: DEB transarterial chemoembolization appears to be a safe and effective treatment option for patients with BCLC C HCC. Patients with Child-Pugh class A without PVT and metastasis benefited most from DEB transarterial chemoembolization.

Original languageEnglish (US)
Pages (from-to)307-315
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2013
Externally publishedYes

Fingerprint

Doxorubicin
Hepatocellular Carcinoma
Safety
Pharmaceutical Preparations
Liver Neoplasms
Survival
Neoplasm Metastasis
Terminology
National Cancer Institute (U.S.)
alpha-Fetoproteins
Survival Analysis
Drug-Related Side Effects and Adverse Reactions
Proportional Hazards Models
Ascites
Nausea
Abdominal Pain
Vomiting
Liver Diseases
Chronic Disease
Liver

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma. / Prajapati, Hasmukh; Dhanasekaran, Renumathy; El-Rayes, Bassel F.; Kauh, John S.; Maithel, Shishir K.; Chen, Zhengjia; Kim, Hyun S.

In: Journal of Vascular and Interventional Radiology, Vol. 24, No. 3, 01.03.2013, p. 307-315.

Research output: Contribution to journalArticle

Prajapati, Hasmukh ; Dhanasekaran, Renumathy ; El-Rayes, Bassel F. ; Kauh, John S. ; Maithel, Shishir K. ; Chen, Zhengjia ; Kim, Hyun S. / Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma. In: Journal of Vascular and Interventional Radiology. 2013 ; Vol. 24, No. 3. pp. 307-315.
@article{c9795f675ae24837b2e1ba4773ad6ffc,
title = "Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma",
abstract = "Purpose: To investigate the safety and efficacy of transarterial chemoembolization using doxorubicin drug-eluting beads (DEBs) in patients with Barcelona Clinic Liver Cancer (BCLC) C stage hepatocellular carcinoma (HCC). Methods: Consecutive patients with initial staging of BCLC C HCC who received DEB transarterial chemoembolization over the last 5 years were studied. The study included 121 patients (mean age, 61.2 years old). Adverse events (AEs) after DEB transarterial chemoembolization were studied in detail and were recorded as per the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria. Survivals were analyzed according to parameters from the time of first DEB transarterial chemoembolization. Kaplan-Meier method by log-rank test and Cox proportional hazard model were used for survival analysis. Results: AEs occurred in 30.2{\%} of patients. No AEs were greater than Common Terminology Criteria for Adverse Events grade III. Grade I and II AEs included nausea and vomiting in 7.8{\%} of patients and abdominal pain in 23.8{\%} of patients. Grade III AEs were noted in 1.06{\%} of patients. There were no gastrointestinal or hepatic complications. There were no deaths within 30 days after DEB transarterial chemoembolization. The overall median survival was 13.5 months. Among the Child-Pugh class A patients, those without PVT and metastasis (28.9{\%}) had better survival when treated with DEB transarterial chemoembolization than those with PVT and metastases (9.9{\%}) (18.8 mo versus 4.4 mo, P =.001). Ascites, performance status, Okuda stage HCC, serum alpha fetoprotein levels, and etiologic factor for chronic liver disease predicted survival. Conclusions: DEB transarterial chemoembolization appears to be a safe and effective treatment option for patients with BCLC C HCC. Patients with Child-Pugh class A without PVT and metastasis benefited most from DEB transarterial chemoembolization.",
author = "Hasmukh Prajapati and Renumathy Dhanasekaran and El-Rayes, {Bassel F.} and Kauh, {John S.} and Maithel, {Shishir K.} and Zhengjia Chen and Kim, {Hyun S.}",
year = "2013",
month = "3",
day = "1",
doi = "10.1016/j.jvir.2012.11.026",
language = "English (US)",
volume = "24",
pages = "307--315",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma

AU - Prajapati, Hasmukh

AU - Dhanasekaran, Renumathy

AU - El-Rayes, Bassel F.

AU - Kauh, John S.

AU - Maithel, Shishir K.

AU - Chen, Zhengjia

AU - Kim, Hyun S.

PY - 2013/3/1

Y1 - 2013/3/1

N2 - Purpose: To investigate the safety and efficacy of transarterial chemoembolization using doxorubicin drug-eluting beads (DEBs) in patients with Barcelona Clinic Liver Cancer (BCLC) C stage hepatocellular carcinoma (HCC). Methods: Consecutive patients with initial staging of BCLC C HCC who received DEB transarterial chemoembolization over the last 5 years were studied. The study included 121 patients (mean age, 61.2 years old). Adverse events (AEs) after DEB transarterial chemoembolization were studied in detail and were recorded as per the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria. Survivals were analyzed according to parameters from the time of first DEB transarterial chemoembolization. Kaplan-Meier method by log-rank test and Cox proportional hazard model were used for survival analysis. Results: AEs occurred in 30.2% of patients. No AEs were greater than Common Terminology Criteria for Adverse Events grade III. Grade I and II AEs included nausea and vomiting in 7.8% of patients and abdominal pain in 23.8% of patients. Grade III AEs were noted in 1.06% of patients. There were no gastrointestinal or hepatic complications. There were no deaths within 30 days after DEB transarterial chemoembolization. The overall median survival was 13.5 months. Among the Child-Pugh class A patients, those without PVT and metastasis (28.9%) had better survival when treated with DEB transarterial chemoembolization than those with PVT and metastases (9.9%) (18.8 mo versus 4.4 mo, P =.001). Ascites, performance status, Okuda stage HCC, serum alpha fetoprotein levels, and etiologic factor for chronic liver disease predicted survival. Conclusions: DEB transarterial chemoembolization appears to be a safe and effective treatment option for patients with BCLC C HCC. Patients with Child-Pugh class A without PVT and metastasis benefited most from DEB transarterial chemoembolization.

AB - Purpose: To investigate the safety and efficacy of transarterial chemoembolization using doxorubicin drug-eluting beads (DEBs) in patients with Barcelona Clinic Liver Cancer (BCLC) C stage hepatocellular carcinoma (HCC). Methods: Consecutive patients with initial staging of BCLC C HCC who received DEB transarterial chemoembolization over the last 5 years were studied. The study included 121 patients (mean age, 61.2 years old). Adverse events (AEs) after DEB transarterial chemoembolization were studied in detail and were recorded as per the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria. Survivals were analyzed according to parameters from the time of first DEB transarterial chemoembolization. Kaplan-Meier method by log-rank test and Cox proportional hazard model were used for survival analysis. Results: AEs occurred in 30.2% of patients. No AEs were greater than Common Terminology Criteria for Adverse Events grade III. Grade I and II AEs included nausea and vomiting in 7.8% of patients and abdominal pain in 23.8% of patients. Grade III AEs were noted in 1.06% of patients. There were no gastrointestinal or hepatic complications. There were no deaths within 30 days after DEB transarterial chemoembolization. The overall median survival was 13.5 months. Among the Child-Pugh class A patients, those without PVT and metastasis (28.9%) had better survival when treated with DEB transarterial chemoembolization than those with PVT and metastases (9.9%) (18.8 mo versus 4.4 mo, P =.001). Ascites, performance status, Okuda stage HCC, serum alpha fetoprotein levels, and etiologic factor for chronic liver disease predicted survival. Conclusions: DEB transarterial chemoembolization appears to be a safe and effective treatment option for patients with BCLC C HCC. Patients with Child-Pugh class A without PVT and metastasis benefited most from DEB transarterial chemoembolization.

UR - http://www.scopus.com/inward/record.url?scp=84874775503&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874775503&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2012.11.026

DO - 10.1016/j.jvir.2012.11.026

M3 - Article

VL - 24

SP - 307

EP - 315

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 3

ER -