Aims and objectives
According to BCLC staging system,
HCC patients with well preserved liver function (Child Pugh A-B),
portal vein tumor thrombosis or extrahepatic spread are classified as “advanced” or stage C and they present dismal prognosis.
In these kind of patients and in those tumors progressing upon loco-regional therapies,
the treatment of choice is represented by Sorafenib,
an oral multikinase inihibitor that significant prolongs time to progression but without significant differences in time to...
Methods and materials
A single-center phase II study was conducted on 24 consecutive HCC patients (13 intermediate-stage non responder and 11-advanced stage stage) dismissing Sorafenib due to unbearable side effects or worsened clinical conditions (deteriorated liver function),
who underwent DSM-TACE. Under local anesthesia,
through femoral approach,
the treatment was performed after selective lobar hepatic artery catheterization.
Based on extent and distribution of the disease and according to the protocol,
A total of 86 treatments were performed.
defined as the ability to deliver the total planned dose or to obtain stop flow,
was achieved in all patients.
No intra- or peri-procedural complications occurred and in particular no signs of liver failure or systemic toxicity were detected.
At 1-month follow-up,
an objective response rate (ORR) of 45.9% and overall disease control (ODC) of 79.2% were observed.
In nine patients with ODC and residual viable tumor higher than 50%,
DSM-TACE seems to be a promising option for intermediate and advanced HCC patients ineligible for Sorafenib administration or dismissing it due to progressive disease or unbearable side effects.
Transarterial chemoembolization with degradable starch microspheres (DSM-TACE): an alternative option for advancedHCC patients? Preliminary results ; R.
and Hepatocatt Study Group; Eur Rev Med Pharmacol Sci 2016; 20 (13): 2872-2877 Interventional treatment for unresectable hepatocellular carcinoma; Murata S,