Circulating DNA changes are predictive of disease progression after transarterial chemoembolization

2021 ◽  
Author(s):  
David Sefrioui ◽  
Vincent Verdier ◽  
Céline Savoye‐Collet ◽  
Ludivine Beaussire ◽  
Slim Ghomadi ◽  
...  
Keyword(s):  
Disease Progression ◽  
Transarterial Chemoembolization ◽  
Circulating Dna

scholarly journals Predictive Factors for the Effectiveness of Repeated Lines of Transarterial Chemoembolization in the Treatment of Localized Hepatocellular Carcinoma

2021 ◽  
Vol 4 (1) ◽  
pp. 42-52
Author(s):  
V. V. Breder ◽  
M. Y. Pitkevich ◽  
V. Y. Kosirev ◽  
B. I. Dolgushin ◽  
E. R. Virshke ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Disease Progression ◽  
Predictive Factors ◽  
Transarterial Chemoembolization ◽  
Local Progression ◽  
The World ◽  
Intrahepatic Tumor

Hepatocellular carcinoma (HCC) remains the fourth leading cause of cancer-related death in the world. The progression of HCC after previously effective TACE is quite often local. This article describes our experience with repeated TACE in patients with local progression of HCC. We analyzed 125 patients with HCC, for the period from 2009 to 2015. TACE was performed for intrahepatic manifestations of HCC. Progression of HCC after TACE-1 was observed in 88.8 % (n = 111) patients. Disease progression after TACE‑2 was registered in 40 (32 %) patients. TACE‑3 was performed in 8 (6.4 %) patients. The analysis showed that isolated local intrahepatic progression of HCC with the growth of intrahepatic tumor nodes previously subjected to TACE‑1 (without new foci) does not affect OS. The efficiency of re-embolization (TACE‑2) is somewhat lower than for TACE of the first stage. Independent factors of overall survival increase in patients receiving TACE: satisfactory objective status according to ECOG, efficacy of the first stage of TACE, late progression and objective effect after re-embolization. 

scholarly journals Clinical efficacy of external beam radiotherapy complementing incomplete transarterial chemoembolization for hepatocellular carcinoma

2020 ◽  
Author(s):  
Sunmin Park ◽  
Won Sup Yoon ◽  
Mi Hee Jang ◽  
Chai Hong Rim
Keyword(s):  
Disease Progression ◽  
Transarterial Chemoembolization ◽  
External Beam Radiotherapy ◽  
Progression Free Survival ◽  
Albumin Level ◽  
Oncologic Outcomes ◽  
External Beam ◽  
Fractionated Radiotherapy ◽  
Conventionally Fractionated

Purpose: External beam radiotherapy (EBRT) has been commonly applied as salvage or a combination locoregional modality after transarterial chemoembolization (TACE) for hepatocellular carcinomas (HCCs). This study reports oncologic outcomes and feasibility after application of the two modalities in our center. Methods: Forty consecutive patients who underwent EBRT due to incomplete responses of TACE were evaluated. Fourteen patients (35.0%) received stereotactic body radiotherapy (SBRT) and the remaining patients received conventionally fractionated radiotherapy (RT). A majority of patients who underwent SBRT received doses of 27 to 48 Gy in 3~4 fractions (median *EQD2: 57.0 Gy). Conventionally fractionated RT was performed with a median EQD2 of 47.8 Gy. Results: The median follow up duration was 14.4 months (range: 2.6~83.0 months). A majority (77.5%) of patients were regarded as having Child Pugh grade A. The median tumor size was 3.4 cm (range: 0.8~20.1 cm). Ten patients (25.0%) had thrombosis at a main portal branch. The 1~ and 2~year overall survival (OS) and progression free survival (PFS) rates were 82.2% and 42.1% and 55.8% and 32.1%, respectively. The local control rates were 89.1% and 89.1% at 1 and 2 years, respectively. The albumin level was a significant factor affecting OS (p = 0.002), and the BCLC stage significantly affected PFS (p = 0.001). Intrahepatic, out of field recurrence was the main cause of disease progression (60.0%), and distant metastasis developed in 12 patients (30.0%) during follow up. Non classic radiation induced liver disease was seen in five (12.5%) patients, and two (5%) patients experienced grade ≥3 hepatic toxicities. Conclusions: EBRT after incomplete TACE was feasible and yielded favorable oncologic outcomes. However, disease progression related to intrahepatic failure remained a hindrance.

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