Survival, efficacy, and safety of small versus large doxorubicin drug-eluting beads TACE chemoembolization in patients with unresectable HCC

Hasmukh Prajapati, Minzhi Xing, James R. Spivey, Steven I. Hanish, Bassel F. El-Rayes, John S. Kauh, Zhengjia Chen, Hyun S. Kim

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100-300 μm) versus large (300-500 and 500-700 μm) doxorubicin drugeluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS. Ninety-four consecutive patients with unresectable HCC who underwent 269 DEB TACE procedures in 48 months were studied. DEB TACE procedures were performed using different DEB sizes: 100-300 μm (Group A, 59 patients) and with mixed 300-500 and 500-700 μm DEB (Group B, 35 patients). Survival rates were compared between the groups. RESULTS. The overall median survival in groups A and B were 15.1 and 11.1 months, respectively (p = 0.005). Both groups were similar in demographics, tumor burden, and differential staging (p> 0.5). Substratification of overall survival according to Child-Pugh class and Okuda, Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC) staging were significantly higher in group A than in group B (p <0.05). Common terminology criteria for adverse events (CTCAE) grade III adverse events and 30-day mortality were significantly lower in group A than in group B (6.8% vs 20%; p = 0.04, and 0% vs 14.3%; p = 0.001, respectively). The particle size, Child-Pugh class, and serum α-fetoprotein level were significant prognostic indicators of survival on multivariate analysis. CONCLUSION. TACE with 100-300 μm sized DEB is associated with significantly higher survival rate and lower complications than TACE with 300-500 and 500-700 μm sized DEB.

Original languageEnglish (US)
Pages (from-to)W706-W714
JournalAmerican Journal of Roentgenology
Volume203
Issue number6
DOIs
StatePublished - Dec 1 2014

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Doxorubicin
Hepatocellular Carcinoma
Safety
Survival
Liver Neoplasms
Pharmaceutical Preparations
Survival Rate
Fetal Proteins
Neoplasm Staging
Tumor Burden
Particle Size
Terminology
Multivariate Analysis
Demography
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Survival, efficacy, and safety of small versus large doxorubicin drug-eluting beads TACE chemoembolization in patients with unresectable HCC. / Prajapati, Hasmukh; Xing, Minzhi; Spivey, James R.; Hanish, Steven I.; El-Rayes, Bassel F.; Kauh, John S.; Chen, Zhengjia; Kim, Hyun S.

In: American Journal of Roentgenology, Vol. 203, No. 6, 01.12.2014, p. W706-W714.

Research output: Contribution to journalArticle

Prajapati, Hasmukh ; Xing, Minzhi ; Spivey, James R. ; Hanish, Steven I. ; El-Rayes, Bassel F. ; Kauh, John S. ; Chen, Zhengjia ; Kim, Hyun S. / Survival, efficacy, and safety of small versus large doxorubicin drug-eluting beads TACE chemoembolization in patients with unresectable HCC. In: American Journal of Roentgenology. 2014 ; Vol. 203, No. 6. pp. W706-W714.
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abstract = "OBJECTIVE. The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100-300 μm) versus large (300-500 and 500-700 μm) doxorubicin drugeluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS. Ninety-four consecutive patients with unresectable HCC who underwent 269 DEB TACE procedures in 48 months were studied. DEB TACE procedures were performed using different DEB sizes: 100-300 μm (Group A, 59 patients) and with mixed 300-500 and 500-700 μm DEB (Group B, 35 patients). Survival rates were compared between the groups. RESULTS. The overall median survival in groups A and B were 15.1 and 11.1 months, respectively (p = 0.005). Both groups were similar in demographics, tumor burden, and differential staging (p> 0.5). Substratification of overall survival according to Child-Pugh class and Okuda, Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC) staging were significantly higher in group A than in group B (p <0.05). Common terminology criteria for adverse events (CTCAE) grade III adverse events and 30-day mortality were significantly lower in group A than in group B (6.8{\%} vs 20{\%}; p = 0.04, and 0{\%} vs 14.3{\%}; p = 0.001, respectively). The particle size, Child-Pugh class, and serum α-fetoprotein level were significant prognostic indicators of survival on multivariate analysis. CONCLUSION. TACE with 100-300 μm sized DEB is associated with significantly higher survival rate and lower complications than TACE with 300-500 and 500-700 μm sized DEB.",
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T1 - Survival, efficacy, and safety of small versus large doxorubicin drug-eluting beads TACE chemoembolization in patients with unresectable HCC

AU - Prajapati, Hasmukh

AU - Xing, Minzhi

AU - Spivey, James R.

AU - Hanish, Steven I.

AU - El-Rayes, Bassel F.

AU - Kauh, John S.

AU - Chen, Zhengjia

AU - Kim, Hyun S.

PY - 2014/12/1

Y1 - 2014/12/1

N2 - OBJECTIVE. The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100-300 μm) versus large (300-500 and 500-700 μm) doxorubicin drugeluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS. Ninety-four consecutive patients with unresectable HCC who underwent 269 DEB TACE procedures in 48 months were studied. DEB TACE procedures were performed using different DEB sizes: 100-300 μm (Group A, 59 patients) and with mixed 300-500 and 500-700 μm DEB (Group B, 35 patients). Survival rates were compared between the groups. RESULTS. The overall median survival in groups A and B were 15.1 and 11.1 months, respectively (p = 0.005). Both groups were similar in demographics, tumor burden, and differential staging (p> 0.5). Substratification of overall survival according to Child-Pugh class and Okuda, Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC) staging were significantly higher in group A than in group B (p <0.05). Common terminology criteria for adverse events (CTCAE) grade III adverse events and 30-day mortality were significantly lower in group A than in group B (6.8% vs 20%; p = 0.04, and 0% vs 14.3%; p = 0.001, respectively). The particle size, Child-Pugh class, and serum α-fetoprotein level were significant prognostic indicators of survival on multivariate analysis. CONCLUSION. TACE with 100-300 μm sized DEB is associated with significantly higher survival rate and lower complications than TACE with 300-500 and 500-700 μm sized DEB.

AB - OBJECTIVE. The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100-300 μm) versus large (300-500 and 500-700 μm) doxorubicin drugeluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS. Ninety-four consecutive patients with unresectable HCC who underwent 269 DEB TACE procedures in 48 months were studied. DEB TACE procedures were performed using different DEB sizes: 100-300 μm (Group A, 59 patients) and with mixed 300-500 and 500-700 μm DEB (Group B, 35 patients). Survival rates were compared between the groups. RESULTS. The overall median survival in groups A and B were 15.1 and 11.1 months, respectively (p = 0.005). Both groups were similar in demographics, tumor burden, and differential staging (p> 0.5). Substratification of overall survival according to Child-Pugh class and Okuda, Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC) staging were significantly higher in group A than in group B (p <0.05). Common terminology criteria for adverse events (CTCAE) grade III adverse events and 30-day mortality were significantly lower in group A than in group B (6.8% vs 20%; p = 0.04, and 0% vs 14.3%; p = 0.001, respectively). The particle size, Child-Pugh class, and serum α-fetoprotein level were significant prognostic indicators of survival on multivariate analysis. CONCLUSION. TACE with 100-300 μm sized DEB is associated with significantly higher survival rate and lower complications than TACE with 300-500 and 500-700 μm sized DEB.

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