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 symptomatic progression.
about 80% of patients present adverse events (hand-foot syndrome,...
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,
each cycle of therapy consists into two consecutive treatments performed within one month.
in case of unilobar...
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%,
a repeated DSM-TACE treatment was performed....
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.
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Prognosis of hepatocellular carcinoma: the BCLC...