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Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics.

Abstract：

BACKGROUND/AIMS:This study assesses the safety, pharmacokinetics and efficacy of transarterial chemoembolization using drug eluting beads (DEB), an embolizing device that slowly releases chemotherapy to decrease systemic toxicity. METHODS:Twenty-seven Child-Pugh A cirrhotics (76% male, 59% HCV) with untreated large/multifocal HCC received chemoembolization with doxorubicin loaded DEBs at doses adjusted for bilirubin and body surface (range: 47-150 mg). Clinical and analytical data were recorded at 24 and 48 h, 7, 14 and 30 days after first and second TACE. Response rate was assessed by CT at 6 months. Blood samples were obtained in 13 patients at 5, 20, 40, 60, 120 min, 6, 24, 48 and 168 h to determine doxorubicin Cmax and AUC. RESULTS:DEB-TACE was well tolerated with an acceptable safety profile. Two cases developed liver abscess, one leading to death. Response rate was 75% (66.6% on intention-to-treat). Doxorubicin Cmax and AUC were significantly lower in DEB-TACE patients (78.97+/-38.3 ng/mL and 662.6+/-417.6 ng/mLmin) than in conventional TACE (2341.5+/-3951.9 ng/mL and 1812.2+/-1093.7 ng/mLmin, p=0.00002 and p=0.001, respectively). After a median follow-up of 27.6 months, 1- and 2-year survival is 92.5% and 88.9%, respectively. CONCLUSIONS:Chemoembolization using DEBs is an effective procedure with a favorable pharmacokinetic profile.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Varela M,Real MI,Burrel M,Forner A,Sala M,Brunet M,Ayuso C,Castells L,Montañá X,Llovet JM,Bruix J

doi

10.1016/j.jhep.2006.10.020

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

474-81

issue

3

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(06)00629-5

journal_volume

46

pub_type

临床试验,杂志文章

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