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Treatment of large HCC: transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus
C Bartolozzi1, R Lencioni, D Caramella
1Department of Radiology, Santa Chiara University Hospital, Pisa, Italy.
Purpose:
To compare the efficacy of transcatheter arterial chemoembolization (TACE) combined with percutaneous ethanol injection (PEI) versus repeated TACE in the treatment of large hepatocellular carcinoma (HCC).
Materials And Methods:
Fifty-three patients with cirrhosis and a large HCC (main tumor, 3.1-8.0 cm in diameter with no more than two daughter nodules) were enrolled in a prospective, randomized study. Twenty-six patients underwent a single TACE session followed by PEI (TACE-PEI group), whereas 27 patients underwent two to five TACE sessions (TACE group). Both groups of patients were similar with regard to liver function. Follow-up ranged from 8 to 39 months.
Results:
Complete therapeutic responses were higher (P < .05) and tumor recurrences during follow-up were lower (P < .05) in the TACE-PEI group than in the TACE group. Patients in the TACE-PEI group survived longer than those in the TACE group, although the difference was not significant (P > .1). The rates of survival without recurrence were better in the TACE-PEI group than in the TACE group (P < .05).
Conclusion:
Use of a single TACE session combined with PEI is more effective than repeated TACE in the treatment of large HCC.