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  • Title: Retrospective study on the use of different protocols for repeated transarterial chemoembolization in the treatment of patients with hepatocellular carcinoma.
    Author: Vogl TJ, Naguib NN, Nour-Eldin NE, Farshid P, Lehnert T, Gruber-Rouh T, Engels KS.
    Journal: Acad Radiol; 2012 Apr; 19(4):434-9. PubMed ID: 22265853.
    Abstract:
    PURPOSE: To evaluate local tumor control and survival rate after repeated transarterial chemoembolization using two different protocols in hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: A total of 190 patients (mean, 68 years) with HCC were repeatedly treated with transarterial chemoembolization in 4-week intervals. The chemotherapy protocol consisted of mitomycin C alone (n = 111) and mitomycin C with gemcitabine (n = 79). Embolization was performed with lipiodol and microspheres. Tumor response was evaluated by magnetic resonance imaging using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Survival rates were calculated using Kaplan-Meier method. RESULTS: In the mitomycin C-only group, we observed partial response in 38.8% (43/111), stable disease in 27% (30/111), and progressive disease in 34.2% (38/111). In the mitomycin C/gemcitabine group (n = 79), partial response was observed in 43% (34/79), stable disease in 16.5% (13/79) and progressive disease in 40.5% (32/79). The overall 1- and 2-year survival rates were 56% and 28%, respectively. The overall median survival time from the start of transarterial chemoembolization treatment was 15 months. The median survival of patients treated with mitomycin C was 16.5 months and it was 12 months for patients treated with a combination of mitomycin C and gemcitabine. No statistically significant difference between the two groups was observed (P = .7). CONCLUSION: Chemoembolization is an effective minimally invasive therapy option for palliative treatment of HCC patients. Mitomycin C only proves to be effective, the addition of gemcitabine was not advantageous.
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