Ces radiol. 2020, 74(2):108-113 | DOI: 10.55095/CesRadiol2020/020

DSM (degradable starch microspheres) - embolization material expanding the possibilities of transarterial chemoembolisation of the liverOriginal article

Tomáš Rohan, Jakub Hustý, Tomáš Andrašina, Jiří Pánek, Daniel Bartušek, Jaroslav Sedmík, Vlastimil Válek

Klinika radiologie a nukleární medicíny FN Brno a LF MU Brno

Objectives: The potential use of DSM-TACE as a salvage therapeutic option in patients with primary liver malignancy unsuitable for further DEB-TACE.

Methods: 16 patients (2 women; median 70.7 years) with hepatocellular carcinoma originally treated with DEB-TACE (1-7 sessions, median 3 sessions) were treated with DSM-TACE (EmboCept, PharmaCept GmbH, Berlin, Germany) for disease progression, impossibility of selective application or intolerance of DEB-TACE. The primary endopoints of the study were the determination of overall survival and time to progression to advanced stage of HCC (Kaplan-Meier test). Prior to DSM-TACE treatment, HCC was present in unilobary liver disease in 8 patients and bilobary in 8 patients, liver cirrhosis was in 12 patients (9 Child-Pugh A, 3 Child-Pugh B), and thrombosis of the portal vein branches in 2 patients. Response to DSM-TACE was evaluated on post-contrast CT according to mRECIST criteria.

Results: A total of 34 DSM-TACE sessions (median 2 per patient) were performed. One anaphylactic reaction has been reported. Other serious intra and periprocedural complications were not observed. After initial treatment with DSM-TACE, complete response was obtained in 4, partial response in 6, stable disease in 4, and progression in 2 patients. During the follow-up period (27-1001 days, median 287 days), progression to advanced stage of HCC was achieved in 8 patients (4 HCC progression, 1 v. portae thrombosis, 3 performance status deterioration). The median time to progression was 16.8 months, median overall survival from 1.DSM-TACE was 22.3 months, median overall survival from 1.TACE was 36.1 months.

Conclusion: DSM-TACE is another therapeutic option in patients who can no longer be treated with DEB-TACE.

Keywords: hepatocellular carcinoma, transarterial chemoembolisation, survival analysis

Grants and funding:

Publikace vznikla na Masarykově univerzitě v rámci projektů "Význam radiologických intervencí a pokročilých zobrazovacích metod v diagnostice a léčbě onkologických pacientů" (MUNI/A/1488/2019) podpořených z prostředků účelové podpory na specifický vysokoškolský výzkum, kterou poskytlo MŠMT v roce 2019. Dále podpořeno MZ ČR - RVO (FNBr, 65269705).

Accepted: April 6, 2020; Published: June 1, 2020  Show citation