Journal
JOURNAL OF CANCER
Volume 12, Issue 15, Pages 4522-4529Publisher
IVYSPRING INT PUBL
DOI: 10.7150/jca.54650
Keywords
Hepatocellular carcinoma; Chemoembolization; Therapeutic; Microspheres; Prognosis
Categories
Funding
- Zhejiang Provincial Natural Science Foundation of China [LZ18H180001]
- National Natural Science Foundation of China [81971713]
- National S&T Major Project of China [2018ZX10301201]
- Health Commission of Zhejiang Province [JBZX-202004]
- Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences [2019RU019]
- Research Fund for Interventional Oncology of China Health Promotion Foundation [XM_2018_011_0006_01]
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This study evaluated the safety and efficacy of DEB-TACE with CSM in HCC patients with PVTT and found that higher Child-Pugh classification and tumor burden were significant prognostic factors for poor OS.
Objective: To prospectively evaluate the safety and therapeutic effectiveness of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) with CalliSpheres (R) microsphere (CSM) for the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), and to analyze the prognostic factors. Method: Between November 2015 and November 2017, consecutive 58 HCC patients with PVTT who received DEB-TACE with CSM treatment were prospectively enrolled in this study. The demographic characteristics, adverse events (AEs) and treatment response were collected. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the independent factors correlated with OS. Results: The objective response rate (ORR) was 79.3% in terms of tumors and 44.8% in thrombi. The median PFS and OS of patients were 5.0 months and 9.0 months respectively. The cumulative survival rate at 3-, 6-, 9-, 12-, 18- and 24-month were 94.8%, 72.4%, 53.4%, 41.4%, 22.4% and 19.0%, respectively. In a stepwise multivariate Cox proportional hazards model, the higher Child-Pugh classification (HR=2.279; 95%CI, 1.042-4.985, p = 0.039) and tumor burden (p = 0.008) were the significant predictors of poorer OS after adjustment for known risk factors. The most common clinical AEs were postembolization syndrome (PES) and the most prevalent laboratory toxicity was transient liver function damage. Conclusion: DEB-TACE with CSM is safe and well-tolerated in HCC patients with PVTT, and reveals a favorable preliminary clinical outcome. The higher Child-Pugh classification and liver tumor burden are independent prognostic factors associated with poor survival for HCC patients with PVTT treated by DEB-TACE with CSM.
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