Single- versus Triple-Drug Chemoembolization for Hepatocellular Carcinoma: Comparing Outcomes by Toxicity, Imaging Response, and Survival

Samdeep K Mouli, Ryan M Hickey, Bartley Garver Thornburg, Kent T Sato, Kush R Desai, Ahmed Gabr, Joseph R. Kallini, Halla Niemeri, Sheetal Mehta Kircher, Mary Frances Mulcahy, Al B Benson III, Ramona Gupta, Riad Salem, Robert J Lewandowski*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS). Materials and Methods A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated. Results Median TTP was similar between groups: 7.9 months (95% confidence interval [CI], 7.1–9.4) and 6.8 months (95% CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients. Conclusions Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.

Original languageEnglish (US)
Pages (from-to)1279-1287
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Hepatocellular Carcinoma
Survival
Liver Neoplasms
Pharmaceutical Preparations
Drug Therapy
Doxorubicin
Confidence Intervals
Ethiodized Oil
Reaction Time
Liver
Neoplasms
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{a2f8e32662104d21a0428410adfad516,
title = "Single- versus Triple-Drug Chemoembolization for Hepatocellular Carcinoma: Comparing Outcomes by Toxicity, Imaging Response, and Survival",
abstract = "Purpose To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS). Materials and Methods A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated. Results Median TTP was similar between groups: 7.9 months (95{\%} confidence interval [CI], 7.1–9.4) and 6.8 months (95{\%} CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients. Conclusions Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.",
author = "Mouli, {Samdeep K} and Hickey, {Ryan M} and Thornburg, {Bartley Garver} and Sato, {Kent T} and Desai, {Kush R} and Ahmed Gabr and Kallini, {Joseph R.} and Halla Niemeri and Kircher, {Sheetal Mehta} and Mulcahy, {Mary Frances} and {Benson III}, {Al B} and Ramona Gupta and Riad Salem and Lewandowski, {Robert J}",
year = "2016",
month = "9",
day = "1",
doi = "10.1016/j.jvir.2016.01.135",
language = "English (US)",
volume = "27",
pages = "1279--1287",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "9",

}

TY - JOUR

T1 - Single- versus Triple-Drug Chemoembolization for Hepatocellular Carcinoma

T2 - Comparing Outcomes by Toxicity, Imaging Response, and Survival

AU - Mouli, Samdeep K

AU - Hickey, Ryan M

AU - Thornburg, Bartley Garver

AU - Sato, Kent T

AU - Desai, Kush R

AU - Gabr, Ahmed

AU - Kallini, Joseph R.

AU - Niemeri, Halla

AU - Kircher, Sheetal Mehta

AU - Mulcahy, Mary Frances

AU - Benson III, Al B

AU - Gupta, Ramona

AU - Salem, Riad

AU - Lewandowski, Robert J

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Purpose To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS). Materials and Methods A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated. Results Median TTP was similar between groups: 7.9 months (95% confidence interval [CI], 7.1–9.4) and 6.8 months (95% CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients. Conclusions Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.

AB - Purpose To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS). Materials and Methods A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated. Results Median TTP was similar between groups: 7.9 months (95% confidence interval [CI], 7.1–9.4) and 6.8 months (95% CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients. Conclusions Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.

UR - http://www.scopus.com/inward/record.url?scp=84962447645&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962447645&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2016.01.135

DO - 10.1016/j.jvir.2016.01.135

M3 - Article

C2 - 27062355

AN - SCOPUS:84962447645

VL - 27

SP - 1279

EP - 1287

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 9

ER -