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Idarubicin vs doxorubicin in transarterial chemoembolization of intermediate stage hepatocellular carcinoma

World Journal of Gastroenterology 2020年第3期26卷 324-334页

作者： gael Stephane roth Yann Teyssier Melodie Abousalihac Arnaud Seigneurin Julien Ghelfi Christian Sengel Thomas Decaens Clinique Universitaire d’Hepato-Gastroenterologie et Oncologie Digestive CHU Grenoble-AlpesGrenoble 38043France Facultede Medicine Universite Grenoble-AlpesDomaine de la MerciLa Tronche 38700France Institute for Advanced Biosciences-INSERM U1209/CNRS UMR 5309/Universite Grenoble-Alpes Site Santé-Allée des AlpesLa Tronche 38700France Clinique Universitaire de Radiologie et Imagerie Médicale CHU Grenoble-AlpesGrenoble 38043France Departement de Sante Publique-CHU Grenoble-Alpes Grenoble 38043France Department of Hepatology and Gastroenterology Grenoble-Alpes University HospitalGrenoble 38043France

BACKGROUND Liver cancer is the fifth most common cancer and the second cause of cancerrelated deaths *** chemoembolization(TACE)is the best treatment of intermediate hepatocellular carcinoma(HCC).Doxorubicin is the most commonly used drug despite a low level of *** To compare the objective response rate of idarubicin-based TACE(Ida-TACE)against doxorubicin-based TACE(Dox-TACE)in intermediate stage *** Between January 2012 and December 2014,all patients treated with TACE at our academic hospital were *** criteria were patients with Child-Pugh score A or B,a performance status below or equal to 1,and no prior *** lipiodol TACE or drug-eluting beads TACE could be performed with 10 mg of idarubicin or 50 mg of *** patient treated with idarubicin was matched with two doxorubicin-treated *** TACE response was assessed by independent radiologists according to the mRECIST *** Sixty patients were treated with doxorubicin and thirty with *** were 93%and 87%of cirrhotic patients and 87%and 70%of Child-Pugh A in the doxorubicin and idarubicin groups,*** median number of HCC per patient was two in both groups with 31%and 26%of single nodules in doxorubicin and idarubicin groups,*** response rate after first TACE was 76.7%and 73.3%(P=0.797)with 41.7%and 40.0%complete response in doxorubicin and idarubicin groups,***-free survival was 7.7 mo in both groups,and liver transplant-free survival was 24.9 mo and 21.9 mo in doxorubicin and idarubicin groups,*** profiles were similar in both groups,with grade 3-4 adverse events in 35%of Dox-TACE and 43%of *** Ida-TACE and Dox-TACE showed comparable results in terms of efficacy and ***-TACE may represent an interesting alternative to Dox-TACE in the management of patients with intermediate stage HCC.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Idarubicin Doxorubicin Intermediate stage

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Impact of sarcopenia on tumor response and survival outcomes in patients with hepatocellular carcinoma treated by trans-arterial (chemo)-embolization

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World Journal of Gastroenterology 2022年第36期28卷 5324-5337页

作者： gael roth Yann Teyssier Maxime Benhamou Mélodie Abousalihac Stefano Caruso Christian Sengel Olivier Seror Julien Ghelfi Arnaud Seigneurin Nathalie Ganne-Carrie Elia Gigante Lorraine Blaise Olivier Sutter Thomas Decaens Jean-Charles Nault Univ.Grenoble-Alpes Grenoble 38058France Department of Hepatology Gastroenterology and Digestive OncologyCHU Grenoble AlpesGrenoble 38043France Institute for Advanced Biosciences INSERM U1209/CNRS UMR 5309Grenoble 38043France Department of Radiology CHU Grenoble AlpesGrenoble 38043France Department of Radiology CHU Avicenne-APHPBobigny 93000France Functional Genomics of Solid Tumors Laboratory Centre de Recherche des Cordeliers-INSERM UMR 1138InsermUniversitéParisParis 75006France Unitéde Formation et de Recherche SantéMédecine et Biologie Humaine UniversitéParis NordParis 93430France Service d'Epidémiologie et Evaluation Médicale CHU Grenoble AlpesGrenoble 38043France Department of Hepatology CHU Avicenne-APHPBobigny 93000France

BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to *** is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-*** Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were *** was assessed using skeletal muscle index at baseline and at the first radiological *** response was recorded after the first session of treatment using *** Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,*** was present in 57.7%of the *** with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic ***,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Bland embolization Sarcopenia Skeletal muscle index

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