Safety and Efficacy of Transarterial Radioembolization Combined with Chemoembolization for Bilobar Hepatocellular Carcinoma: A Single-Center Retrospective Study

• DOI: 10.1007/s00270-017-1826-7
• Publication Date: 2017-10-24T15:43:57Z
• Authors: Joon Ho Kwon; Gyoung Min Kim; Kichang Han; Jong Yun Won; Man Deuk Kim; Do Yun Lee; Junhyung Lee; Woosun Choi; Yong Seek Kim; Do Young Kim; Kwang-Hyub Han
• Keywords: Adult; Male; Carcinoma, Hepatocellular; Hepatocellular carcinoma; Brachytherapy; Transarterial radioembolization; 610; Transarterial chemoembolization; 03 medical and health sciences; 0302 clinical medicine; Humans; Yttrium Radioisotopes; Radioembolization induced liver disease; Chemoembolization, Therapeutic; Aged; Retrospective Studies; Aged, 80 and over; Antibiotics, Antineoplastic; Liver Neoplasms; Iodized Oil; Middle Aged; Combined Modality Therapy; 3. Good health; Treatment Outcome; Doxorubicin; Barcelona clinic liver cancer (BCLC); Female; Follow-Up Studies

Radioembolization induced liver disease (REILD) is a possible sequela of transarterial radioembolization (TARE), particularly in cases of whole-liver treatment. To mitigate this problem, the safety and efficacy of combined transarterial chemoembolization (TACE) and TARE were evaluated for patients with bilobar hepatocellular carcinoma (HCC).Nineteen patients (mean age 60 years; range 27-82 years) treated for HCC between June 2012 and September 2014 were included in the analysis. Each patient was treated with combined TARE and TACE for bilobar HCC, with or without portal vein thrombosis. The hepatic lobe with large HCC was treated with TARE, and the other lobe with small HCC(s) was treated with TACE. Laboratory and clinical data were investigated to determine REILD occurrence. Survival data were analyzed to compare the treatment efficacy of alternative treatment modalities, including TACE and sequential TARE.All patients underwent TARE for a dominant tumor in one lobe and TACE for small nodule(s) in the other lobe of the liver. The mean yttrium-90 microspheres used in TARE were 2.8 GBq (range; 1.0-3.5 GBq), and the mean doses of doxorubicin and iodized oil were 24.5 mg and 5.2 mL, respectively, for TACE. No statistical differences were noted between laboratory data measured before and after treatment, and no procedure-related major clinical complications occurred. The median time-to-progression of patients was 10.0 months, and the median overall survival was 27.3 months.Combined radioembolization and chemoembolization appears to be a safe and effective treatment modality for bilobar HCC.