Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comparing two types of drug-eluting beads

Janek Grumme; Thomas Werncke; Timo C Meine; Lena S Becker; Roman Kloeckner; Sabine K Maschke; Martha M Kirstein; Arndt Vogel; Frank K Wacker; Bernhard C Meyer; Jan B Hinrichs; Thomas Rodt

doi:10.1007/s00261-019-02349-w

Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comparing two types of drug-eluting beads

Abdom Radiol (NY). 2020 Oct;45(10):3326-3336. doi: 10.1007/s00261-019-02349-w.

Authors

Affiliations

¹ Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
² Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Mainz, Germany.
³ Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
⁴ Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany. hinrichs.jan@mh-hannover.de.
⁵ Institute for Diagnostic and Interventional Radiology, Klinikum Lüneburg, Lüneburg, Germany.

^# Contributed equally.

PMID: 31781900
DOI: 10.1007/s00261-019-02349-w

Abstract

Purpose: To compare two different types of drug-eluting microspheres with regard to impact on HRQoL after first TACE, tumour response, peri-procedural complications, adverse events and 1-year survival in patients suffering from unresectable hepatocellular carcinoma (HCC).

Methods: HRQoL was prospectively assessed with validated questionnaires (EORTC QLQ-C30 and -HCC18) before and 2 weeks after treatment with their first drug-eluting beads (DEB-)TACE with either acrylamido-polyvinylalcohol-AMPS hydrogel microspheres (group^DCB; 20 patients) or polyvinyl alcohol-co-acrylic acid microspheres (group^HS; 16 patients). Baseline characteristics, peri-procedural complications, treatment-related adverse events and 1-year survival were compared between both types of microspheres. Treatment response and objective response rates (ORR) were analysed using established tumour response criteria. Subgroup analysis for pooled groups with small (group^SMALL; 21 patients) versus large particles (group^LARGE; 15 patients) was performed.

Results: At baseline, there were no significant differences between the treated microsphere groups. No significant differences were found in absolute HRQoL changes after first DEB-TACE between the different types of microspheres. Response rates and survival were comparable between the investigated microsphere groups. For group^SMALL, we found a significant difference in post-interventional deterioration of physical function (- 19.4%) compared to group^LARGE (- 8%; p = 0.025). Tumour response and ORR according to mRECIST were significantly higher in group^SMALL (p = 0.008; p = 0.009).

Conclusion: DEB-TACE is generally well tolerated and effective, with comparable changes in HRQoL for both types of drug-eluting microspheres. Tumour response is better with small microspheres. A relevant deterioration of physical function underlines that an aggressive TACE using small beads should be well deliberated.

Keywords: EORTC; HRQLQ-C30/-HCC18; Hepatocellular carcinoma; Palliative therapy; Quality of life; Transarterial chemoembolization.

MeSH terms

Antibiotics, Antineoplastic / therapeutic use
Carcinoma, Hepatocellular* / drug therapy
Chemoembolization, Therapeutic*
Doxorubicin
Humans
Liver Neoplasms* / drug therapy
Pharmaceutical Preparations*
Quality of Life
Treatment Outcome

Substances

Antibiotics, Antineoplastic
Pharmaceutical Preparations
Doxorubicin