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CardioVascular and Interventional Radiology

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01-12-2017 | Clinical Investigation

Safety and Efficacy of Transarterial Radioembolisation in Patients with Intermediate or Advanced Stage Hepatocellular Carcinoma Refractory to Chemoembolisation

Authors: Elisabeth G. Klompenhouwer, Raphaëla C. Dresen, Chris Verslype, Annouschka Laenen, Gert De Hertogh, Christophe M. Deroose, Lawrence Bonne, Vincent Vandevaveye, Geert Maleux

Published in: CardioVascular and Interventional Radiology | Issue 12/2017

Abstract

Introduction

Transarterial chemoembolisation (TACE) is the most widely used locoregional treatment for patients with an unresectable hepatocellular carcinoma (HCC). Transarterial radioembolisation (TARE) with yttrium-90 containing microspheres is an emerging interventional treatment that could be complementary or an alternative to TACE.

Aim

To evaluate the safety and efficacy of TARE in patients with HCC who are refractory to TACE with drug-eluting beads (DEB-TACE).

Methods

We identified all patients who received TARE for HCC following one or more sessions of DEB-TACE in the period 2007–2016. Grade ≥3 adverse events were graded according to Common Terminology Criteria for Adverse events. Response on MRI was determined on MRI by modified RECIST. Overall survival was estimated using the Kaplan–Meier method and was determined from the first TACE and from the TARE procedure.

Results

A total of 30 patients were included. Patients had a mean of 1.7 TACE procedures (range 1–4) prior to TARE. Grade 3 adverse events following TARE included: fatigue (20%), bilirubin increase (10%), cholecystitis (3.3%) and a gastric ulcer (3.3%). Response on MRI was achieved in 36.7%. Three patients (10%) were downstaged within the Milan criteria and received liver transplantation. The median overall survival after first TACE was 32.3 months (17.2–42.1 95% CI). The median overall survival after TARE was 14.8 months (8.33–26.5 95% CI).

Conclusion

TARE is safe and can be effective in patients with an intermediate or advanced stage HCC who are refractory to TACE. This treatment strategy has the potential to downstage to liver transplantation.

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Title: Safety and Efficacy of Transarterial Radioembolisation in Patients with Intermediate or Advanced Stage Hepatocellular Carcinoma Refractory to Chemoembolisation
Authors: Elisabeth G. Klompenhouwer
Raphaëla C. Dresen
Chris Verslype
Annouschka Laenen
Gert De Hertogh
Christophe M. Deroose
Lawrence Bonne
Vincent Vandevaveye
Geert Maleux
Publication date: 01-12-2017
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 12/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1739-5

At a glance: The STEP trials

Springer Medicine

Safety and Efficacy of Transarterial Radioembolisation in Patients with Intermediate or Advanced Stage Hepatocellular Carcinoma Refractory to Chemoembolisation

Abstract

Introduction

Aim

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Aim

Methods

Results

Conclusion

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