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Transcatheter Arterial Chemoembolization with Epirubicin-Loaded Superabsorbent Polymer Microspheres for 135 Hepatocellular Carcinoma Patients: Single-Center Experience

Transcatheter Arterial Chemoembolization with Epirubicin-Loaded Superabsorbent Polymer Microspheres for 135 Hepatocellular Carcinoma Patients: Single-

Transcatheter Arterial Chemoembolization with Epirubicin-Loaded Superabsorbent Polymer Microspheres for 135 Hepatocellular Carcinoma Patients: Single-Center Experience   (Citations: 4)
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Purpose  To evaluate the safety, clinical outcomes, and hepatic artery damage after transcatheter arterial chemoembolization (TACE) with epirubicin-loaded superabsorbent polymer microspheres (ELM-TACE) in patients with hepatocellular carcinoma (HCC) in a single center in Japan. Materials and Methods  This embolic agent is the original form of microspheres, which has the same composition and nature as HepaSpheres. Between May 2007 and June 2009, 135 patients with unresectable HCC who underwent ELM-TACE were enrolled. Embolization through extrahepatic collaterals was performed in 27 (20.0%) patients. Tumor response was evaluated using European Association for the Study of the Liver criteria at 1 and 6 months after initial ELM-TACE. Results  All procedures were successfully performed. The median number of TACE per patient was 1.7 sessions (range 1–5), and the mean epirubicin dose per session was 19.7 mg (range 2.0–60.0). Local pooling within target tumors was observed during TACE in 34 (25.2%) patients, and in 14 (10.4%) of the patients, gelatin sponge particles were added after the microspheres until each pooling disappeared. No serious adverse events associated with TACE occurred, and the incidence of postembolization syndrome was ≤17.8%. The 1- and 6-month tumor response rates were 56.3 and 52.6%, respectively. The overall 1- and 2-year survival rates were 73.7 and 59.0%, respectively. Among 99 evaluated patients, 90 (90.9%) were found to have no hepatic artery damage after initial ELM-TACE. Conclusion  ELM-TACE is safe and effective treatment for unresectable HCC and is associated with low frequency of postembolization syndrome and minimal damage to the hepatic artery.
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    • ...Super-absorbant polymer (SAP) (amine-acrylate) microspheres (Hepasphere/Quadrasphere, Merit Medical, South Jordan, UT) have demonstrated utility in the treatment of hepatocellular carcinoma as a bland embolic [6]...

    David M. LiuSebastianet al. Optimization of Doxorubicin Loading for Superabsorbent Polymer Microsp...

    • ...Local pooling of the contrast material within the target tumor, resembling extravasation or blood sinus, is often observed during TACE with microspheres [17, 19]...
    • ...We are now trying to allow 50–100-lm HepaSphere to absorb highlyconcentrated cisplatin solubilized in iomeprol 350 mgI/ml, in a similar manner to that described for epirubicin-loaded microspheres [17]...
    • ...TACE with DEM may be less likely to cause liver dysfunction and postembolization syndrome than conventional TACE regardless of the type of anticancer drug used, and therefore the patient’s liver function and general condition are maintained even after repeated TACE with DEM [17]...

    Akihiko Sekiet al. Switching the Loaded Agent from Epirubicin to Cisplatin: Salvage Trans...

    • ...Our choice of drug-eluting microspheres (DEM) for performing TACE is a spherical embolic agent HepaSphere (Merit Medical Systems, Utah, USA) loaded with various chemotherapeutic agents [2, 3]. Since February 2009, a pilot study has been in progress to evaluate palliative TACE with docetaxel (DOC)-loaded microspheres in some patients with liver metastases who are refractory to the current standard treatments and in whom liver metastases are ...
    • ...DEM loaded with anthracycline anticancer agents or CDDP has been reported for the treatment of hepatocellular carcinoma [2, 3, 9]. On the other hand, DEM loaded with irinotecan or oxaliplatin also has been reported for the treatment of liver metastases and intrahepatic cholangiocarcinoma [10, 11]...

    Akihiko Sekiet al. Transcatheter arterial chemoembolization with docetaxel-loaded microsp...

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