Abstract
We evaluated the early results of transcatheter arterial chemoembolization (TACE) with superabsorbent polymer microspheres (SAP-MS) loaded with chemotherapeutic agents in patients with unresectable hepatocellular carcinoma (HCC). Between February 2008 and April 2009, 39 patients (31 male and 8 female, mean age 74.6 years) were treated with TACE using SAP-MS loaded with cisplatin (IAC-SAP TACE) as second or later line therapy. Before the IAC-SAP TACE therapy, all the patients had been treated with multiple sessions of conventional TACE with epirubicin, lipiodol, and gelatin sponge particles, but they had relapsed more frequently. The diameter of the maximum treated lesions ranged from 10 to 140mm (mean 50.2mm), and 37 patients (94.9%) had multiple liver tumors. A total of 56 sessions of IAC-SAP TACE were performed (mean, 1.6 sessions per patient). Response rate after one month of initial IAC-SAP TACE was 46.2% and 23.1% by EASL and RECIST criteria. The median overall survival time was 341 days (range, 66-401 days) calculated using the Kaplan-Meier method. No major complications were observed and 34 patients (87.2%) had no postembolization syndrome (fever, abdominal pain, and/or vomiting). IAC-SAP TACE was a safe therapeutic option for advanced multiple HCC. We are currently planning a phase II trial of IAC-SAP TACE as first line therapy for unresectable HCC.
