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Il Giornale Italiano di Radiologia Medica 2018 Luglio-Agosto;5(4):496-501

DOI: 10.23736/S2283-8376.18.00087-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Transcatheter arterial chemo-embolization using degradable starch microspheres in the treatment of hepatocarcinoma: new frontiers in downstaging and in tumor angiogenesis inhibition

Lucio TARANTO 1, Roberto MINICI 1, Giuseppe MAZZARELLA 1, Massimo DE SIENA 2, Francesco MANTI 1, Maria PETULLÀ 1, Domenico LAGANÀ 1

1 Unità di Radiologia, Dipartimento di Medicina Clinica e Sperimentale, Azienda Ospedaliero-Universitaria Mater Domini, Catanzaro, Italia; 2 Unità di Epatologia, Azienda Ospedaliero-Universitaria Mater Domini, Catanzaro, Italia


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BACKGROUND: The aim of this study was to evaluate transcatheter arterial chemo-embolization using degradable starch microspheres as a valid therapeutic option in the treatment of single HCC lesions in patients not eligible for surgical resection and in the downstaging of mass-forming HCC ensuring permanence in transplant list.
METHODS: From January 2016 to May 2018, 13 patients were enrolled (6 with single HCC, 5 multifocal HCC, 2 mass-forming HCC), not eligible to surgical treatment and which have not received other locoregional therapies. DSM-TACE was performed in all patients using transcatheter degradable starch microspheres (EmboCept®) and doxorubicin. Baseline and follow-up CT and/or MRI was assessed after 1, 3, 6, and 12 months evaluating the response to treatment according to m-RECIST criteria.
RESULTS: DSM-TACE were performed in all patients enrolled, with no major clinical complications. Four complete responses and two partial responses were obtained in patients with single HCC. Two complete responses and three partial responses were obtained in patients with multifocal HCC. Two partial responses were obtained in mass-forming HCC.
CONCLUSIONS: DSM-TACE reduces neo-angiogenetic stimulus by necrosis produced and, compared to definitive embolization techniques, it seems to be safer by reducing post-embolization syndrome incidence, ensuring similar outcome.


KEY WORDS: Response evaluation criteria in solid tumors - Degradable starch microspheres - Doxorubicin - Therapeutic embolization - Hepatocellular carcinoma - Diagnostic imaging

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