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Quimioembolización arterial transcatéter

01 febrero 2015

AMERICAN JOURNAL OF ROENTGENOLOGY. Survival Outcomes in Patients With Advanced Hepatocellular Carcinoma Treated With Drug-Eluting Bead Chemoembolization

Charles E. Ray Jr., Anthony C. Brown, Tyler J. Green, Helena Winston, Casey Curran, Sarah M. Kreidler, Deborah H. Glueck and Paul J. Rochon

OBJECTIVE. The purpose of this study was to determine the overall survival rates in patients with advanced hepatocellular carcinoma (HCC) who undergo treatment with drug-eluting bead (DEB) therapy.

01 febrero 2015

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile

Carlo Spreafico, Tommaso Cascella, Antonio Facciorusso, Carlo Sposito, Lanocita Rodolfo, Carlo Morosi, Enrico M. Civelli, Marta Vaiani, Sherrie Bhoori, Alessandro Pellegrinelli, Alfonso Marchianò, Vincenzo Mazzaferro

Purpose: To evaluate the short-term safety and efficacy of the new generation of 70–150 µm drug-eluting beads (M1 DEB) in patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) as a primary therapy or as a bridge to liver transplantation (LT).

01 diciembre 2014

AMERICAN JOURNAL OF ROENTGENOLOGY. Survival, Efficacy, and Safety of Small Versus Large Doxorubicin Drug-Eluting Beads TACE Chemoembolization in Patients With Unresectable HCC

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

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 drug-eluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC).

01 septiembre 2014

RADIOLOGY. CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I. Development, Growth, and Spread: Key Pathologic and Imaging Aspects

Jin-Young Choi, MD, Jeong-Min Lee, MD, Claude B. Sirlin, MD

Hepatocellular carcinoma (HCC) is an epithelial tumor originating in the liver and composed of cells with characteristics similar to those of normal hepatocytes (1). It is the fifth most common tumor in the world, and its incidence is increasing, especially in Western nations (2). Cirrhosis is the most important clinical risk factor for HCC, with approximately 80% of cases of HCC developing in patients with a cirrhotic liver (3). In such patients, the annual incidence of HCC ranges from 2% to 8% (4,5). The exact incidence depends on the cause of cirrhosis (highest incidence in those infected with hepatitis C virus or hepatitis B virus), severity of cirrhosis (highest incidence in those with decompensated cirrhosis), geographic region (higher in Japan than in Europe or United States), and sex (higher in men than women). The risk is greater in individuals with multiple risk factors as well as in those coinfected with human immunodeficiency virus (6). Patients without cirrhosis also may develop HCC, especially those with long-standing chronic liver inflammation due to hepatitis B virus or hepatitis C virus infection (7) or nonalcoholic steatohepatitis (8), but at a much lower rate than those with cirrhosis. Other risk factors for HCC include heavy alcohol consumption, tobacco smoking (9), obesity, diabetes, hereditary hemochromatosis, high dietary consumption of aflatoxins, and family history of HCC (6). Importantly, cirrhosis and chronic hepatitis now are recognized as risk factors for intrahepatic cholangiocarcinoma (ICC) as well as HCC (10); thus, many patients at risk for HCC may develop ICC instead.

01 abril 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Safety and Effectiveness of Chemoembolization with Drug-Eluting Beads for Advanced-Stage Hepatocellular Carcinoma

Sanjeeva P. Kalva, Melina Pectasides, Raymond Liu, Niranjan Rachamreddy, Shravani Surakanti, Kalpana Yeddula, Suvranu Ganguli, Stephan Wicky, Lawrence S. Blaszkowsky, Andrew X. Zhu

Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC.

01 abril 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Comparison of Local Control in Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma ≤6 cm With or Without Intraprocedural Monitoring of the Embolized Area Using Cone-Beam Computed Tomography

Shiro Miyayama, Masashi Yamashiro, Masahiro Hashimoto, Nanako Hashimoto, Masaya Ikuno, Kenichiro Okumura, Miki Yoshida, Osamu Matsui

Purpose: This study was designed to compare technical success and local recurrence rates of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with/without monitoring of embolized areas using cone-beam computed tomography (CBCT).

01 abril 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Trends in Utilization of Transarterial Treatments for Hepatocellular Carcinoma: Results of a Survey by the Italian Society of Interventional Radiology

Irene Bargellini, Francesco Florio, Rita Golfieri, Maurizio Grosso, Dario Luca Lauretti, Roberto Cioni

Purpose: This study was designed to provide an overview of the practice of locoregional treatments for HCC by the Italian centers of Interventional Radiology (IR) with particular reference to transarterial modalities.

01 abril 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Repeated Bland-TAE Using Small Microspheres Injected via an Implantable Port–Catheter System for Liver Metastases: An Initial Experience

Toshihiro Tanaka, Hideyuki Nishiofuku, Shinsaku Maeda, Testuya Masada, Hiroshi Anai, Hiroshi Sakaguchi, Kimihiko Kichikawa

Purpose: The purpose of this pilot study was to assess the effectiveness of repeated bland-TAE using small-size microspheres for liver metastases. To date, there have been no publications as to whether bland-TAE could be effective for nonhypervascular liver tumors.

01 marzo 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Comparison of Characteristics and Transarterial Chemoembolization Outcomes in Patients with Unresectable Hepatocellular Carcinoma and Different Viral Etiologies

Bang-Bin Chen, MD , I-Lun Shih, MD , Chih-Horng Wu, MD , Chiun Hsu, MD, PhD , Chien-Hung Chen, MD, PhD , Tiffany Ting-Fang Shih, MD , Kao-Lang Liu, MD , Po-Chin Liang, MD

Purpose: To determine any differences in patient characteristics and outcomes after transarterial chemoembolization between different viral etiologies of hepatocellular carcinoma (HCC).

01 marzo 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Drug-Eluting Beads Loaded with Antiangiogenic Agents for Chemoembolization: In Vitro Sunitinib Loading and Release and In Vivo Pharmacokinetics in an Animal Model

Katrin Fuchs, PharmD , Pierre E. Bize, MD , Olivier Dormond, MD, PhD , Alban Denys, MD , Eric Doelker, PhD , Gerrit Borchard, PhD , Olivier Jordan, PhD

Purpose: The combination of embolic beads with a multitargeted tyrosine kinase inhibitor that inhibits tumor vessel growth is suggested as an alternative and improvement to the current standard doxorubicin-eluting beads for use in transarterial chemoembolization. This study demonstrates the in vitro loading and release kinetics of sunitinib using commercially available embolization microspheres and evaluates the in vitro biologic efficacy on cell cultures and the resulting in vivo pharmacokinetics profiles in an animal model.

01 marzo 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Transarterial Therapy of Hepatocellular Carcinoma Fed by the Right Renal Capsular Artery

Masaki Ishikawa, MD , Takuji Yamagami, MD , Hideaki Kakizawa, MD , Masashi Hieda, MD , Naoyuki Toyota, MD , Wataru Fukumoto, MD , Kenji Kajiwara, MD , Rika Yoshimatsu, MD , Hiroshi Aikata, MD , Kazuaki Chayama, MD , Kazuo Awai, MD

Purpose: To evaluate the characteristics of hepatocellular carcinomas (HCCs) fed by the right renal capsular artery and to assess the tumor response and complications in patients treated with transarterial therapy via the renal capsular arteries with or without other extrahepatic arteries and/or intrahepatic arteries.

01 marzo 2014

RADIOLOGY. Chemoembolization for Hepatocellular Carcinoma: 1-Month Response Determined with Apparent Diffusion Coefficient Is an Independent Predictor of Outcome

Vincent Vandecaveye, MD, PhD, Katrijn Michielsen, MSc, Frederik De Keyzer, MSc, Wim Laleman, MD, PhD, Mina Komuta, MD, PhD, Katya Op de beeck, MD, Tania Roskams, MD, PhD, Frederik Nevens, MD, PhD, Chris Verslype, MD, PhD, Geert Maleux, MD, PhD

Purpose: To evaluate the predictive utility of apparent diffusion coefficient (ADC) changes at diffusion-weighted (DW) magnetic resonance (MR) imaging 1 month after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) compared with the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, European Association for the Study of the Liver (EASL) criteria, and modified RECIST (mRECIST).

01 febrero 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Transcatheter Arterial Chemoembolization (TACE) of Colorectal Cancer Liver Metastases by Irinotecan-Eluting Microspheres in a Salvage Patient Population

Peter Huppert, Thorsten Wenzel, Hubertus Wietholtz

Purpose: This prospective study evaluated the effectiveness and safety of TACE using irinotecan loaded superabsorbent polymer (SAP) microspheres for treatment of colorectal cancer liver metastases (CCLM) in a salvage setting of patients.

01 enero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma with Portal Vein Invasion: Safety, Efficacy, and Prognostic Factors

Ming-Chih Chern, MD , Vincent P. Chuang, MD , Chung-Ting Liang, MD , Z.H. Lin, MD , Tse-Ming Kuo, MD

Purpose: To evaluate the safety and efficacy of transarterial chemoembolization and to identify the prognostic factors associated with survival in patients with hepatocellular carcinoma (HCC) and portal vein (PV) invasion.

1 diciembre 2013

WORLD JOURNAL OF GASTROENTEROLOGY. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation

Maurizio Pompili, Giampiero Francica, Francesca Romana Ponziani, Roberto Iezzi and Alfonso Wolfango Avolio.

Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). The most used treatments include transarterial chemoembolization and radiofrequency ablation. Surgical resection has also been successfully used as a bridging procedure, and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function. The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation, reducing HCC recurrence after transplantation, and improving post-transplant overall survival. To date, no data from prospective randomized studies are available; however, for HCC patients listed for LT within the Milan criteria, prolonging the waiting time over 6-12 mo is a risk factor for tumor spread. Bridging treatments are useful in containing tumor progression and decreasing dropout. Furthermore, the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT. Lastly, although a definitive conclusion can not be reached, the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival. Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT. Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.

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