Transarterial chemoembolization with doxorubicin-loaded radiopaque beads for hepatocellular carcinoma: Safety, efficacy, and distribution

Radiologia Pub Date : 2025-07-01 DOI:10.1016/j.rxeng.2025.101656

A. Páez-Carpio , P. Bermúdez , M. Sanduzzi Zamparelli , M. Barrufet , O. Arrabal , A. Forner , A. Darnell , J. Bruix , F. Torres , M. Reig , M. Burrel

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Abstract

Aim

To evaluate the safety and efficacy of transarterial chemoembolization with radio-paque doxorubicin-loaded microspheres (rDEB-TACE) in patients with hepatocellular carcinoma (HCC).

Materials and methods

This single-center, retrospective, observational study included all patients 18 years and older diagnosed with HCC and treated with rDEB-TACE from 2017 to 2020 at our institution. rDEB-TACE efficacy was evaluated by type of response after treatment at 1-,3- and 6-month, time to progression (TTP), and overall survival (OS). Safety of the techniquewas assessed based on the occurrence of adverse events (AEs). rDEB distribution was classified by overall distribution as type 1: intratumoral, type 2: intratumoral-feeding artery, and type 3: feeding artery and by intratumoral distribution in 0–50% and 50–100%.

Results

Twenty-one patients with 36 lesions treated with rDEB-TACE were included. Median follow-up time was 17 months (IQR: 6.0–45.5). Local and overall objective response at 1, 3 and 6 months was 86%, 85%, 84% and 91%, 78% and 84%, respectively. Median TTP was 27.0 months (95%CI: 8.9–28.1) and median OS was 54.9 months (95%CI: 16.3-NE). No major AEs were reported. The most common particle distribution was type 2 (69.4%). Concordance of particle distribution between intraprocedural cone beam CT and follow-up CT was high (kappa = 0.80). Most lesions treated showed a 50-100% intratumoral particle distribution, with higher rates of local (95.5% vs 71.4%) and overall objective response in this group (100% vs 71.4%) compared with the 0–50% group.

Conclusion

rDEB-TACE is a safe and effective treatment for patients with HCC. Distribution of rDEB can be accurately assessed during and after the procedure and may predict early response.

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载多柔比星不透射线珠经动脉化疗栓塞治疗肝癌：安全性、有效性和分布

目的评价放射性多柔比星微球（rDEB-TACE）经动脉化疗栓塞治疗肝细胞癌（HCC）的安全性和有效性。材料和方法本研究为单中心、回顾性、观察性研究，纳入我院2017年至2020年期间所有18岁及以上确诊为HCC并接受rDEB-TACE治疗的患者。rDEB-TACE的疗效通过治疗后1、3和6个月的反应类型、进展时间（TTP）和总生存期（OS）来评估。该技术的安全性是根据不良事件（ae）的发生来评估的。rDEB分布按总体分布分为1型：瘤内，2型：瘤内供血动脉，3型：供血动脉，按瘤内分布0-50%和50-100%。结果采用rDEB-TACE治疗的36例病变共21例。中位随访时间为17个月（IQR: 6.0 ~ 45.5）。1个月、3个月和6个月的局部和总体客观缓解率分别为86%、85%、84%和91%，78%和84%。中位TTP为27.0个月（95%CI: 8.9-28.1），中位OS为54.9个月（95%CI: 16.3-NE）。没有重大爆炸事件的报告。最常见的颗粒分布为2型（69.4%）。术中锥束CT与随访CT颗粒分布一致性高（kappa = 0.80）。大多数治疗的病变显示50-100%的瘤内颗粒分布，与0-50%组相比，该组局部（95.5% vs 71.4%）和总体客观缓解率（100% vs 71.4%）更高。结论rdeb - tace治疗肝癌安全有效。rDEB的分布可以在手术期间和手术后准确评估，并可以预测早期反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Radiologia

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