TITLE:
Use of Initial Modified RECIST Tumor Response Evaluation Criteria for Predicting Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization with Drug-Eluting Beads
AUTHORS:
Natália Sousa Freitas Queiroz, Luciana Kikuchi, Regis Otaviano Franca Bezerra, Regiane S. S. M. Alencar, Aline Lopes Chagas, Cláudia Megumi Tani, Márcio Augusto Diniz, Aline Cristine Barbosa Santos, Airton Mota Moreira, Manoel de Souza Rocha, Luiz Augusto Carneiro D’Albuquerque, Francisco César Carnevale, Flair José Carrilho
KEYWORDS:
Hepatocellular Carcinoma, mRECIST Criteria, Transarterial Chemoembolization, Overall Survival, Drug-Eluting Beads
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.13,
December
2,
2015
ABSTRACT: Introduction: Transarterial chemoembolization (TACE) reduces tumor growth
and increases survival in patients with hepatocellular carcinoma (HCC).
Drug-eluting beads (DEB) deliver slow-release chemotherapy and reduce systemic
toxicity during TACE. This study correlated initial tumor response according to
modified RECIST (mRECIST) criteria and 1-year survival in patients with HCC
treated with TACE-DEB, and identified predictors of tumor response. Methods:
Fifty-two patients with HCC received TACE-DEB loaded with doxorubicin 75 mg
during a 6-month period. Tumor response was evaluated 1 month after the
procedure according to mRECIST criteria. Results: Most patients were cirrhotic
and etiology of liver disease was hepatitis C in 26/52 (50%). Similar numbers
of patients had Barcelona Clinic Liver Cancer (BCLC) A and BCLC B disease. Most
patients had one nodule (66%). Complete response (CR) was achieved in 12/52
(23%), partial response in 19/52 (37%), stable disease in 4/52 (8%) and
progressive disease in 17/52 (32%). Largest HCC ≤58 mm and BCLC stage A were
associated with CR. The 1-year survival was 74%, with survival rates of 95% and
56% in the BCLC A and B groups, respectively. Variables reflecting tumor extension were associated with better survival. CR
according to mRECIST criteria was a predictor of better 1-year survival
(100% vs. 64%, P studies are needed to evaluate other predictors of
survival and to determine if tumor response predicts long-term survival.