Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study
Received 13 September 2018
Accepted for publication 27 June 2019
Published 10 February 2020 Volume 2020:12 Pages 941—956
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Xueqiong Zhu
Bin Liang, 1,* Hua Xiang, 2,* Cong Ma, 3 Bin Xiong, 1 Yilong Ma, 4 Chang Zhao, 4 Yuanhui Yao, 2 Zishu Zhang, 3 Changyong Chen, 5 Haiping Li, 5 Qingyun Long, 6 Jun Zhou, 6 Chao Luo, 7 Huaiming Qiu, 7 Hongyao Hu, 8 Hui Zhao, 8 Guofeng Zhou, 1 Chuansheng Zheng 1
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Interventional Radiology, Hunan Provincial People’s Hospital, Changsha, People’s Republic of China; 3Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China; 4Department of Interventional Radiology, Cancer Hospital Affiliated to Guangxi Medical University, Nanning, People’s Republic of China; 5Department of Radiology, Xiangya Hospital General South University, Changsha, People’s Republic of China; 6Department of Interventional Radiology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 7Department of Radiology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, People’s Republic of China; 8Department of Interventional Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chuansheng Zheng
Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, People’s Republic of China
Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, People’s Republic of China
Purpose: This study aimed to compare the efficacy and safety between transarterial chemoembolization (TACE) with CalliSpheres® microspheres (CSM-TACE) and conventional TACE (cTACE) in patients with hepatocellular carcinoma (HCC).
Patients and Methods: Three hundred and thirty-five HCC patients receiving CSM-TACE or cTACE were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into CSM-TACE group and cTACE group accordingly. Complete response (CR), objective response (ORR) and disease control response (DCR) was assessed according to mRECIST criteria at 1 month (M1), 3 months(M3) and 6 months(M6) after treatment. Progression-free survival (PFS) and overall survival (OS) were assessed. Liver function indexes and adverse events (AEs) were also evaluated.
Results: CR at M3 (P=0.020) and ORR at M1 (P< 0.001), M3 (P< 0.001) and M6 (P=0.017) after treatment were significantly higher in the CSM-TACE compared with cTACE group. DCRs, PFS (25.3 months vs 24.2 months, P=0.503) and OS (27.8 months vs 25.3 months, P=0.203) were similar between the two groups. CSM-TACE was independently correlated with higher ORR at M1 (P=0.002) and longer OS (P=0.023). Abnormal alkaline phosphatase (ALP) (P=0.049) was independently associated with lower ORR at M3, and history of alcohol intake (P=0.019) and largest nodule size ≥ 7 cm (P=0.015) independently correlated with lower ORR at M6 (P=0.015). Largest nodule size ≥ 7 cm (P=0.029) and abnormal albumin (ALB) (P=0.046) were independently associated with shorter PFS. Child-Pugh stage B/C (P=0.023), abnormal ALB (P=0.001), ALP (P=0.008) and alpha-fetoprotein (AFP) (P=0.005) were independently associated with shorter OS. Most liver function indexes and AEs were similar between the two groups (P> 0.05), except that ALP (P=0.005), total bilirubin (P=0.031), pain during procedure (P=0.034) and occurrence of fever post(treatment (P=0.017) were significantly elevated in the CSM-TACE compared with cTACE group.
Conclusion: CSM-TACE presents with a better treatment response and similar survival profile compared with cTACE in HCC patients.
Keywords: chemoembolization, CalliSpheres microspheres, hepatocellular carcinoma, treatment response, survival, predictive factor
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