Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola
{"title":"传统、DEB和DSM：哪一种技术可用于中期HCC的姑息性TACE ？结果70例患者的疗效和耐受性。","authors":"Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola","doi":"10.1007/s11547-025-02069-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.</p><p><strong>Materials and methods: </strong>Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.</p><p><strong>Results: </strong>Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.</p><p><strong>Conclusions: </strong>In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Conventional vs. DEB vs. DSM: Which technique for palliative TACE in intermediate-stage HCC? Results on 70 patients in terms of efficacy and tolerance.\",\"authors\":\"Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola\",\"doi\":\"10.1007/s11547-025-02069-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.</p><p><strong>Materials and methods: </strong>Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.</p><p><strong>Results: </strong>Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.</p><p><strong>Conclusions: </strong>In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.</p>\",\"PeriodicalId\":20817,\"journal\":{\"name\":\"Radiologia Medica\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiologia Medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11547-025-02069-w\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiologia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11547-025-02069-w","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Conventional vs. DEB vs. DSM: Which technique for palliative TACE in intermediate-stage HCC? Results on 70 patients in terms of efficacy and tolerance.
Purpose: This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.
Materials and methods: Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.
Results: Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.
Conclusions: In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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