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CardioVascular and Interventional Radiology

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01-06-2010 | Clinical Investigation

Prospective Randomized Comparison of Chemoembolization with Doxorubicin-Eluting Beads and Bland Embolization with BeadBlock for Hepatocellular Carcinoma

Authors: Katerina Malagari, Mary Pomoni, Alexis Kelekis, Anastasia Pomoni, Spyros Dourakis, Themis Spyridopoulos, Hippokratis Moschouris, Emmanouil Emmanouil, Spyros Rizos, Dimitrios Kelekis

Published in: CardioVascular and Interventional Radiology | Issue 3/2010

Abstract

The purpose of this study was to evaluate the added role of a chemotherapeutic in transarterial chemoembolization (TACE) of intermediate-stage hepatocellular carcinoma (HCC). The issue is of major importance since, as suggested by recent evidence, hypoxia or incomplete devascularization of the tumor is a potent stimulator of angiogenesis, and there are not many papers supplying level one evidence confirming the value of a chemotherapeutic. The hypothesis was that since drug-eluting bead (DEB)-TACE is standardized and reproducible, a comparison with bland TACE can readily reveal the potential value of the chemotherapeutic. Two groups were randomized in this prospective study: group A (n = 41) was treated with doxorubicin DEB-TACE, and group B (n = 43) with bland embolization. Patients were randomized for tumor diameter. Patients were embolized at set time intervals (2 months), with a maximum of three embolizations. Tumor response was evaluated using the EASL criteria and α-fetoprotein levels. At 6 months a complete response was seen in 11 patients (26.8%) in the DEB-TACE group and in 6 patients (14%) in the bland embolization group; a partial response was achieved in 19 patients (46.3%) and 18 (41.9%) patients in the DEB-TACE and bland embolization groups, respectively. Recurrences at 9 and 12 months were higher for bland embolization (78.3% vs. 45.7%) at 12 months. Time to progression (TTP) was longer for the DEB-TACE group (42.4 ± 9.5 and 36.2 ± 9.0 weeks), at a statistically significant level (p = 0.008). In conclusion, DEB-TACE presents a better local response, fewer recurrences, and a longer TTP than bland embolization with BeadBlock. However, survival benefit and bland embolization with smaller particles must be addressed in future papers to better assess the clinical value.

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Title: Prospective Randomized Comparison of Chemoembolization with Doxorubicin-Eluting Beads and Bland Embolization with BeadBlock for Hepatocellular Carcinoma
Authors: Katerina Malagari
Mary Pomoni
Alexis Kelekis
Anastasia Pomoni
Spyros Dourakis
Themis Spyridopoulos
Hippokratis Moschouris
Emmanouil Emmanouil
Spyros Rizos
Dimitrios Kelekis
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2010
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-009-9750-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prospective Randomized Comparison of Chemoembolization with Doxorubicin-Eluting Beads and Bland Embolization with BeadBlock for Hepatocellular Carcinoma

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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