Ces radiol. 2015, 69(2):106-115 | DOI: 10.55095/CesRadiol2015/017

The survival of patients with hepatocellular carcinoma treated by transarterial chemoembolization with drug-eluting beadsOriginal article

Monika Staňková1, Tomáš Andrašina1, Jaroslav Sedmík1, Vlastimil Válek1, Lenka Ostřížková2, Štěpán Tuček3
1 Radiologická klinika FN, Brno
2 Interní hematoonkologická klinika FN, Brno
3 Klinika komplexní onkologické péče MOÚ, Brno

Aim: To evaluate the survival of patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) with drug-eluting beads, to evaluate the correlation of the length of survival with the factors related to primary liver tumour and factors related to interventions, treatment and response to treatment. Another aim is to evaluate the interobserver variability of measurement in the evaluation response to treatment using RECIST and mRECIST criteria and volumetry.

Methods: The total of 49 patients treated in the University Hospital Brno with the diagnosis of HCC were included in this retrospective study. The tumour range was evaluated on the CT/MR input and output by two independent doctors. The survival of the patients was evaluated since the date of the first TACE, in relation to well-known factors effecting the treatment of HCC. The survival was evaluated by the Kaplan-Meier method and the differences in survival by the log-rank test. The interobserver variability was determined by using Pearson and Spearman correlation coefficient.

Results: The strongest correlation has been proven between the length of survival and determination of the viable part of tumour using volumetry and the ratio viable/aviable parts of the tumour. The median of survival since the first performed TACE is 17.1 months. The evaluation of the response to treatment using RECIST and mRECIST criteria and volumetry has been proven with statistically significant small interobserver variability; however, the best result was achieved by using volumetric analysis.

Conclusion: TACE with drug-eluting beads is a modern method of treatment of HCC. When evaluating the response to treatment, it is convenient to use volumetric analysis.

Keywords: drug-eluting beads, hepatocellular carcinoma, RECIST, transarterial chemoembolization, volumetric analysis
Grants and funding:

Práce vznikla v rámci projektu MUNI/A/1001/2013 Grantové agentury MU.

Accepted: April 10, 2015; Published: June 1, 2015  Show citation

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Staňková M, Andrašina T, Sedmík J, Válek V, Ostřížková L, Tuček Š. The survival of patients with hepatocellular carcinoma treated by transarterial chemoembolization with drug-eluting beads. Ces radiol. 2015;69(2):106-115. doi: 10.55095/CesRadiol2015/017.
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    References

    1. Brůha R. Hepatocelulární karcinom - možnosti a realita. Sborník č. 1. Postgraduální medicína. Praha 2011.
    2. Kiss I, Válek V, Kala Z. Hepatocelulární karcinom - možnosti léčby v roce 2011. Postgraduální medicína 08/11. 2011.
    3. Rostambeigi N, Dekarske AS, Austin EE, et al. Cost effectiveness of radioembolization compared with conventional transarterial chemoembolization fot treatment of hepatocellular carcinoma. Journal of Vascular and Interventional Radiology 2014; 25(7): 1075-1084. Go to original source... Go to PubMed...
    4. Kubala E, Chovanec V, Priester P. Sekvenční podání lokoregionální léčby TACE a biologické léčby sorafenib v léčbě hepatocelulárního karcinomu u stádií B a C. XXXVI. Brněnské onkologické dny a XXVI. Konference pro sestry a laboranty 2012.
    5. Spreafico C, Cascella T, Facciorusso A, et al. Transarterial chemoembolization for hepatocellular carcinoma with a new generation of beads: clinical-radiological outcomes and safety profile. Cardiovasc Intervent Radiol 2015; 38(1): 129-134. Go to original source... Go to PubMed...
    6. Golfieri R, Giampalma E, Renzulli M, et al. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma. Br J Cancer 2014; 111(2): 255-264. Go to original source... Go to PubMed...
    7. Lammer J, Malagari K, Vogl T, et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 2010; 33(1): 41-52. Go to original source... Go to PubMed...
    8. Bruix J, Sherman M, Llovet JM, et al. EASL Panel of Experts on HCC: Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 2001; 35: 421-430. Go to original source... Go to PubMed...
    9. Ray S, Hagge R, Gillen M, et al. Comparison of two-dimensional and three-dimensional iterative watershed segmentation methods in hepatic tumor volumetrics. Med Phys 2008; 35: 5869-5881. Go to original source... Go to PubMed...
    10. Drever L, Robinson DM, McEwan A, et al. A local contrast based approach to threshold segmentation for PET target volume delineation. Med Phys 2006; 33: 1583-1594. Go to original source... Go to PubMed...
    11. Monsky WL, Kim I, Loh S, et al. Semiautomated Segmentation for Volumetric Analysis of Intratumoral Ethiodol Uptake and Subsequent Tumor Necrosis After Chemoembolization. American Journal of Roentgenology 2010; 195: 1220-1230. Go to original source... Go to PubMed...
    12. Rothe JH, Grieser C, Lehmkuhl L, et al. Size determination and response assessment of liver metastases with computed tomography-comparison of RECIST and volumetric algorithms. Eur J Radiol 2013; 82(11): 1831-1839. Go to original source... Go to PubMed...
    13. Eisenhauera EA, Therasse P, Bogaert J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). European Journal of Cancer 2009; 45: 228-247. Go to original source... Go to PubMed...
    14. Riccardo Lencioni MD, Josep M, Llovet MD. Modified RECIST (mRECIST) Assessment for Hepatocellular Carcinoma. Semin Liver Dis 2010; 30(1): 52-60. Go to original source... Go to PubMed...
    15. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1(8476): 307-310. Go to original source...
    16. Li H, Li B, Wei Y, et al. Preoperative transarterial chemoembolization does not increase hepatic artery complications after liver transplantation: A single center 12-year experience. Clin Res Hepatol Gastroenterol 2015 [Epub ahead of print]. Go to original source... Go to PubMed...
    17. Duras P, Šlauf F, Novák M, et al. Transarteriální chemoembolizace jater pomocí částic uvolňující léčivo - naše zkušenosti. Ces Radiol 2009; 63(2): 138-144.
    18. Kim YI, Park JW, Kwak HW, et al. Long-term outcomes of second treatment after initial transarterial chemoembolization in patients with hepatocellular carcinoma. Liver Int 2014; 34(8): 1278-1286. Go to original source... Go to PubMed...
    19. Colombo M, Sangiovanni A. Treatment of hepatocellular carcinoma: beyond international guidelines. Liver Int 2015; 35(Suppl 1): 129-138. Go to original source... Go to PubMed...
    20. Chen J, Xi W, Wu B, Yu H, Chen S. Clinical observation of transcatheter arterial chemoembolization plus sorafenib in the treatment of hepatocellular carcinoma with portal vein tumor thrombosis. Zhonghua Yi Xue Za Zhi 2014; 94(33): 2566-2569. Go to original source... Go to PubMed...
    21. Lencioni R, Chen XP, Dagher L, Venook AP. Treatment of intermediate/advanced hepatocellular carcinoma in the clinic: how can outcomes be improved? Oncologist 2010; 15(Suppl 4): 42-52. Go to original source... Go to PubMed...
    22. Ferda J, Duras P, Třeška V, et al. Transarteriální radioembolizace jaterních nádorů mikročásticemi s 90-yttriem - první zkušenosti. Ces Radiol 2014; 68(2): 85-96.
    23. Bargellini I, Bozzi E, Campani D, et al. Modified RECIST to assess tumor response after transarterial chemoembolization of hepatocellular carcinoma: CT-pathologic correlation in 178 liver explants. Eur J Radiol 2013; 82(5): e212-299. Go to original source... Go to PubMed...
    24. Sacco R. Assessment of radiologic response to targeted therapies in patients with hepatocellular carcinoma. Future Oncol 2014; 10(13): 2073-2079. Go to original source... Go to PubMed...
    25. Chapiro J, Duran R, Lin M, et al. Early survival prediction after intra-arterial therapies: a 3D quantitative MRI assessment of tumour response after TACE or radioembolization of colorectal cancer metastases to the liver. European Radiology 2015 Jan 31 [Epub ahead the print]. Go to original source... Go to PubMed...
    26. Corona-Villalobos CP, Halappa VG, Geschwind JF, et al. Volumetric assessment of tumour response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib. Eur Radiol 2015; 25(2): 380-390. Go to original source... Go to PubMed...
    27. Lin M, Bhagat N, Pellerin O, et al. Volumetric RECIST: an improved way to assess tumor response after transcatheter arterial chemoembolization (TACE). Poster ECR 2012. Go to original source...
    28. Zahel T, Wildgruber M, Ardon R, Schuster T, Rummeny EJ. Rapid assessment of liver volumetry by a novel automated segmentation algorithm. J Comput Assist Tomogr 2013; 37(4): 577-582. Go to original source... Go to PubMed...
    29. Bolte H, Jahnke T, Schäfer FK, et al. Interobserver-variability of lung nodule volumetry considering different segmentation algorithms and observer training levels. Eur J Radiol 2007; 64(2): 285-295. Go to original source... Go to PubMed...
    30. Hayano K, Fuentes-Orrego JM, Sahani DV. New approaches for precise response evaluation in hepatocellular carcinoma. World J Gastroenterol 2014; 20(12): 3059-3068. Go to original source... Go to PubMed...

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