Oily chemoembolization combined with degradable starch microspheres for HCC with cirrhosis
Satoru Murata1, Hiroyuki Tajima, Kazuo Ichikawa
1Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan. genji@nms.ac.jp
Background/Aims:
To assess efficacy of transcatheter arterial chemoembolization (TACE) combined with degradable starch microspheres (DSM) for patients with liver cirrhosis and hepatocellular carcinoma (HCC).
Methodology:
Our studied population was 19 patients with unresectable HCC and liver dysfunction due to repeated TACE, in whom we were unable to selectively advance a microcatheter into the feeding arteries because of tortuous or complex feeding arteries to the HCC. To avoid embolization of an extended non-tumorous area, we conducted Lipiodol-TACE after DSM-embolization (TACE-DSM) of the tumor-free parenchyma. Embolization data and clinical parameters were prospectively assessed.
Results:
TACE-DSM was performed 21 times in the 19 patients, and the overall technical success rate was 81%. The TACE-DSM method did not induce severe liver dysfunction. A favorable response involving necrosis of more than 80% or 50% of the tumor was seen in 62% and 90% of cases, respectively. In the follow-up period (8 to 36 months), complete necrosis of the targeted tumors was observed in 26% of cases. The 2-year survival rates calculated as starting from the date of TACE-DSM therapy was 32.6%.
Conclusions:
From these results we conclude that TACE-DSM therapy is useful for protecting liver function in patients with cirrhosis and unresectable HCC.
