Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: A pilot clinical study☆
Received 27 December 2007; received in revised form 1 March 2008; accepted 26 March 2008. published online 24 April 2008.
Background/Aims
Experimental studies have shown synergy between radiofrequency (RF) ablation and adjuvant chemotherapy in animal tumour models. We aimed to assess safety and efficacy of doxorubicin-eluting bead (DEB)-enhanced RF ablation in the treatment of human hepatocellular carcinoma (HCC).
Methods
Twenty patients with single HCC ranging 3.3–7.0cm (mean, 5.0cm±1.4) showing evidence of residual viable tumour after standard RF ablation underwent intraarterial DEB administration (50–125mg doxorubicin; mean, 60.2mg±21.8). Follow-up period ranged 6–20 months (mean, 12 months±5).
Results
No major complication occurred. No deterioration of liver function was observed. The volume of treatment-induced necrosis – as measured on imaging – increased from 48.1cm3±35.7 after RF ablation to 75.5cm3±52.4 after DEB administration, with an increase of 60.9%±39.0. The enhanced effect resulted in confirmed complete response (CR) of the target lesion in 12 (60%) of 20 patients. Incomplete response with persistence of <10% of initial tumour volume was observed in 6 (30%) of 20 patients, and local tumour progression in 2 (10%) of 20.
Conclusions
Intraarterial DEB administration substantially enhances the effect of RF ablation. DEB-enhanced RF ablation is safe and results in a high rate of CR in patients refractory to standard RF treatment.
1Division of Diagnostic and Interventional Radiology, Department of Oncology and Radiology, Cisanello University Hospital – Building No. 9, Via Paradisa 2, IT-56124 Pisa, Italy
2Division of Hepatology, Department of Liver Transplantation, Hepatology, and Infectious Diseases, Cisanello University Hospital, Via Paradisa 2, IT-56124 Pisa, Italy
3Division of Liver Transplantation, Department of Liver Transplantation, Hepatology, and Infectious Diseases, Cisanello University Hospital, Via Paradisa 2, IT-56124 Pisa, Italy
☆ The authors who have taken part in the research of this paper declared that they do not have a relationship with the manufacturers of the materials involved either in the past or present and they did not receive funding from the manufacturers to carry out their research.
ABSTRACT