Transarterial chemoembolization with pirarubicin-eluting microspheres in patients with unresectable hepatocellular carcinoma: Preliminary results

Mingjun Bai; Tao Pan; Churen Zhou; Ming-An Li; Junwei Chen; Zhaolin Zeng; Duo Zhu; Chun Wu; Zaibo Jiang; Zhengran Li; Mingsheng Huang

doi:10.1016/j.jimed.2019.09.005

Transarterial chemoembolization with pirarubicin-eluting microspheres in patients with unresectable hepatocellular carcinoma: Preliminary results

J Interv Med. 2019 Sep 9;2(2):69-77. doi: 10.1016/j.jimed.2019.09.005. eCollection 2019 May.

Authors

Mingjun Bai^{1

2}, Tao Pan^{1

2}, Churen Zhou^{1

2}, Ming-An Li¹, Junwei Chen^{1

2}, Zhaolin Zeng^{1

2}, Duo Zhu¹, Chun Wu¹, Zaibo Jiang¹, Zhengran Li¹, Mingsheng Huang^{1

2}

Affiliations

¹ Department of Vascular Interventional Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.

Abstract

Purpose: To present the early results of pirarubicin-eluting microsphere transarterial chemoembolization (PE-TACE) for patients with unresectable hepatocellular carcinoma (HCC).

Materials and methods: We retrospectively analyzed 55 consecutive patients with HCC who received PE-TACE between April 1, 2015 and August 30, 2016. The complication rate, tumor response rate, progression-free survival (PFS), and overall survival (OS) were analyzed.

Results: Adverse events were generally mild and included abdominal pain and fever, although a major complication was reported in 1 patient (1.8%). During a median follow-up of 10.0 months (range, 3.0-24.0 months), 14 patients (25.5%) achieved a complete tumor response, 25 (45.5%) had a partial response, 9 (16.4%) showed stable disease, and 7 (12.7%) had disease progression. The 1-month overall response rate was 70.9%, and the local tumor response rate was 89.0%. The 1-month tumor response rate was 100% for Barcelona Clinic Liver Cancer (BCLC) stage A or B disease and 62.8% for BCLC stage C disease. The median PFS was 6.1 months (95% confidence interval [95%CI], 3.4-8.8 months; range, 1.0-24.0 months). The median OS was 11.0 months (95%CI, 7.1-14.9 months; range, 2.0-24.0 months). Kaplan-Meier analysis (log-rank test) found significant differences in OS between patients grouped by tumor number (P = 0.006), tumor size (P = 0.035), and Eastern Cooperative Oncology Group (ECOG) score (P = 0.005). The tumor number (1 vs. ≥2) was the only factor independently associated with OS (hazard ratio [HR], 2.867; 95%CI, 1.330-6.181; P = 0.007).

Conclusions: PE-TACE for unresectable HCC may be safe, with favorable tumor response rates and survival time, especially in patients with a single large tumor. Longer follow-up using a larger series is necessary to confirm these preliminary results.

Keywords: Drug-eluting chemoembolization; Hepatocellular carcinoma; Microspheres; Therapeutic chemoembolization; Treatment outcome.