Comparison of two transarterial chemoembolization strategies for hepatocellular carcinoma.
AIM
This retrospective study aimed to compare the efficacy of and tolerance to two center-related conventional transarterial chemoembolization (TACE) strategies in the management of unresectable hepatocellular carcinoma (HCC).


PATIENTS AND METHODS
All HCC patients in whom TACE was initiated in the two centers from June 2008 to July 2011 were included. The TACE strategy performed in center 1 was "on demand" with selective injections of idarubicin, whereas the TACE strategy in center 2 was based "on scheduled" non-selective injections of epirubicin. Toxicity was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events v4.0.


RESULTS
One hundred and fifty HCC patients were included. Median time to treatment failure was significantly higher in center 1, 13.1 months vs. 7.9 months in center 2 (hazard ratio, 2.32; p<10-3 in multivariate analysis). Median overall survival was 21.1 months in center 1 vs. 18.4 months in center 2 (p=NS). The proportion of grade ≥ 3 adverse events and mean hospitalisation duration for the overall TACE treatment were significantly greater in center 2 than in center 1: 56% vs. 32% (p<0.01) and 14.2 ± 7.2 days vs. 10.3 ± 7.0 days (p<0.01), respectively.


CONCLUSION
Our results failed to show any significant survival differences between two center-related TACE strategies but showed a significantly smaller proportion of grade ≥ 3 adverse events and shorter hospitalisation for the overall treatment when the "on-demand" strategy was used.
['Tavernier|Jerome|J|', 'Fagnoni|Philippe|P|', 'Chabrot|Pascal|P|', 'Guiu|Boris|B|', 'Vadot|Lucie|L|', 'Aho|Serge|S|', 'Boyer|Louis|L|', 'Abergel|Armand|A|', 'Hillon|Patrick|P|', 'Sautou|Valerie|V|', 'Boulin|Mathieu|M|']
D000368:Aged D000903:Antibiotics, Antineoplastic D006528:Carcinoma, Hepatocellular D016461:Chemoembolization, Therapeutic D015251:Epirubicin D004998:Ethiodized Oil D005260:Female D006801:Humans D015255:Idarubicin D007261:Infusions, Intra-Arterial D008113:Liver Neoplasms D008297:Male D012189:Retrospective Studies D016896:Treatment Outcome
Transarterial chemoembolization strategy hepatocellular carcinoma efficacy tolerance