Single- versus Triple-Drug Chemoembolization for Hepatocellular Carcinoma: Comparing Outcomes by Toxicity, Imaging Response, and Survival

详细信息    查看全文

• 作者：Samdeep K. Mouli ; MD^a ; Ryan Hickey ; MD^a ; Bartley Thornburg ; MD^a ; Kent T. Sato ; MD^a ; Kush Desai ; MD^a ; Ahmed Gabr ; MD^a ; Joseph R. Kallini ; MD^a ; Halla Niemeri ; MD^b ; Sheetal Kircher ; MD^b ; Mary F. Mulcahy ; MD^b ; Al B. Benson III ; MD^b ; Ramona Gupta ; MD^a ; Riad Salem ; MD ; MBA^a ; ^b ; Robert J. Lewandowski ; MD^a ; ^{r-lewandowski@northwestern.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：BCLC ; Barcelona Clinic for Liver Cancer ; CI ; confidence interval ; EASL ; European Association for the Study of the Liver ; ECOG ; Eastern Cooperative Oncology Group ; HCC ; hepatocellular carcinoma ; OS ; overall survival ; PVT ; portal vein thrombosis ; TTP ; time to progression ; WHO ; World Health Organization
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：27
• 期：9
• 页码：1279-1287
• 全文大小：426 K

文摘

To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS).

Materials and Methods

A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated.

Results

Median TTP was similar between groups: 7.9 months (95% confidence interval [CI], 7.1–9.4) and 6.8 months (95% CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients.

Conclusions

Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.