| 1. |
M Hirakawa, Y Kikuchi , A Inoue , S Tsuruta, H Sakai, K Mimori, Comparison of microballoon-occluded TACE versus DEB-TACE for the treatment of patients with large and intermediate-stage HCCs, CIRSE 2019, 2019.09, OBJECTIVE:
Recently, microballoon-occluded transarterial chemoembolization (B-TACE) was developed in Japan, B-TACE induce dense lipidol accumulation in targeted hepatocellular carcinomas (HCCs) nodules. However, to the best of our knowledge, no comparison study has yet analyzed outcomes after B-TACE and TACE with drug-eluting-bead (DEB-TACE) in patients with HCC. The purpose of this study is to evaluate the efficacy and safety associated with B-TACE versus DEB-TACE for large (maximal diameter > 5 cm) and intermediate-stage HCCs.
MATERIALS AND METHODS:
This retrospective study involved naïve 35 patients with large and intermediate-stage HCCs who underwent B-TACE (n = 18) or DEB-TACE (n = 17) between April 2013 and May 2016. The decision between B-TACE and DEB-TACE was based on patient choice. Local control of largest tumor 3months after TACE, overall survival (OS) and adverse events (AEs) were compared between the two groups.
RESULTS:
The median duration of follow-up was 19 months (range, 8-48 months). Objective response rate analyzed with modified Response Evaluation Criteria in Solid Tumors (RECIST) was 38.9% after B-TACE and 52.9% after DEB-TACE (P = 0.039). No significant differences could be detected between the B-TACE and DEB-TACE groups with regard to median OS analyzed with the Kaplan-Meier method (28 versus 30 months, respectively; p=0.08). The 1-, 2-, and 3-year OS rates were 72.2, 62.4, and 42.8%, respectively, for the B-TACE and 82.4, 50.2, and 31.4%, respectively, for the DEB-TACE group. Hepatic dysfunction of grade 3 related DEB-TACE occurred in one patient and rate of AEs after DEB-TACE tended to be higher than B-TACE.
CONTCLUSION:
For the treatment of patients with large and intermediate-stage HCCs, DEB-TACE provided better tumor responses in comparison with B-TACE, which in turn DEB-TACE did not seem to improve survival in comparison with B-TACE.
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| 2. |
Masakazu Hirakawa, Radiation protection on patient and physician during Vascular Interventional Radiology for body disease
, The 78th Annual Meeting of the Japan Radiological Society, 2019.04, As minimally invasive procedures in vascular Interventional Radiology (IR) are increasingly adopted and becoming more complex, many IR procedures can result in clinically significant radiation doses to patients and to the physicians and paramedical staff in room. The radiation protection of both patients and medical stuffs is of particular concern. Radiation-induced cataracts secondary to occupational exposure represent a recently recognized entity. In 2011, the International Commission on Radiological Protection (ICRP) recommended reduction the occupational exposure dose limit for the eye lens to 20 mSv/y. However, NRA (Nuclear Regulation Authority, Japan) does not respond to these newly introduced criteria. The NRA considers the action to respond to new criteria for lens of eyes applicable to occupational exposure as introduced in the IAEA safety standard. Recent study reported that occupational eye doses from IR procedures have the potential to exceed the new ICRP equivalent dose limit, particularly if no eye lens protective equipment is always used. Therefore, radiologists are supposed to play a pivotal role for the radiation dose reduction during IR procedures. In this symposium, I would like to emphasize the importance of patients’ dose reduction trial and reliable measurement of operators’ eye dose by using DOSIRIS [direct monitoring of eye lens dose in terms of Hp(3)]under lead glass during IR procedures through my clinical experience and previous studies.. |
| 3. |
Masakazu Hirakawa, Y Asayama, K Ishigami, Y Ushijima, A Nishie, H Honda
, Significant Importance of Novel Direct Eye Dosimeter and Protective Lead Devices for Complying with ICRP Recommended Limit for the Eye Lens in Transarterial Chemoembolization for HCC, Radiological Society of North America's 104th Scientific Assembly and Annual Meeting, 2018.11, Objective This study aimed to evaluate the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS, 3mm dose equivalent, Hp(3)) during transarterial chemoembolization (TACE) for HCC and to investigate possible number of TACE procedures/y within current dose limit of 20 mSv/y.
M&M The measurements of eye doses [Hp(3)]were carried out for 3 Interventional radiologists (IR) (IR1 operator with lead glass and ceiling mounted lead glass screen, IR2 operator without lead glass and with ceiling mounted lead glass screen, IR3 operator without lead glass and ceiling mounted lead glass screen) performing 132 TACE procedures using DOSIRIS. For protective lead devices, wraparound type lead glass eye wear (0.07mmPb) and ceiling mounted lead glass screen are used. To measure the occupational eye dose, DOSIRIS was stuck just lateral to the left eye under lead glass and without lead glass. We calculated the eye dose per TACE procedures and possible number of TACE procedures/ y within current dose limit of 20 mSv/y for each operators.
Result The mean fluoroscopy time, air kerma and dose area product/TACE were 38.2min, 1.45Gy and 200587mGy・cm2, respectively. The eye dose per TACE procedure for 1,2, and 3 operator were 34.8, 72.2, and 240μSv, respectively. The eye dose of IR1 with protective lead devices was significantly lower than IR without protective lead devices (IR3). Possible number of TACE procedures /y within ICRP recommended dose limit of 20 mSv/y for 1, 2, and 3 operator were 574, 277, and 83, respectively.
Conclusion The eye dose limit of 20mSv/y may be exceeded in IR operators who do not use protective lead glasses and ceiling mounted lead glass screen. For complying with ICRP recommendation, protective lead devices and correct evaluation of the eye dose using direct eye dosimeter (Hp(3)) under protective lead glasses might be needed.
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| 4. |
Current status and prospect of B-TACE for hepatocellular carcinoma. |
| 5. |
Masakazu Hirakawa, T Yamanouchi, A Inoue, S Tsuruta, H Sakai, K Mimori, H Honda
, Let’s start Balanced-TACE, JSIR, ISIR 2018, 2018.05. |
| 6. |
Masakazu Hirakawa, Y Torahiko, S Tsuruta, A Inoue, H Sakai, K Mimori, H Honda
, Evaluation of the occupational eye doses estimated using direct eye dosimeter during TACE for HCC
, JSIR, ISIR 2018, 2018.05, Objective This study aimed to evaluate the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS, 3-mm dose equivalent, Hp(3)) during transarterial chemoembolization (TACE) for HCC and to investigate possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1. M&M The eye doses [Hp(3)] of 3 Interventional radiology(IR) operators (1 operator with lead glass and ceiling mounted lead glass screen, 2 operator without lead glass and with ceiling mounted lead glass screen, 3 operator without lead glass and ceiling mounted lead glass screen) were recorded using DOSIRIS. 96 TACE procedures were included in this study. For eye protective equipment, wraparound type lead glass eye wear (0.07mmPb) are used. To measure the occupational eye dose, DOSIRIS was stuck just lateral to the left eye under lead glass and without lead glass. We calculated the eye dose per TACE procedures and possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1for each operators. Result The mean fluoroscopy time, air kerma and dose area product were 38.1 min, 1.62 Gy and 183.2 Gy cm2, respectively. The eye dose per TACE procedure for 1,2, and 3 operator were 35.9μSv, 76.2μSv, and 236.4μSv, respectively. Possible number of TACE procedures y-1 for 1, 2, and 3 operator were 557, 262, and 85, respectively. Conclusion The eye dose limit of 20mSv y-1 may be exceeded in IR operators who do not use protective lead glasses and ceiling mounted lead glass screen. Correct evaluation of the eye dose (Hp(3)) using direct eye dosimeter might be needed.. |
| 7. |
Masakazu Hirakawa, Y Torahiko, H Wakiyama, K Matsumoto, K Sakamoto, S Tsuruta, A Inoue, H Sakai, K Mimori, H Honda
, Comparison of occupational eye radiation dose estimated on novel direct eye dosimeter and film badge in transarterial chemoembolization for hepatocellular carcinoma
, 第77回日本医学放射線学会総会, 2018.04, Objective This study aimed to compare the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS) and film badge during transarterial chemoembolization (TACE) and to investigate possible number of TACE procedures y-1. M&M Thirty six HCC cases (17 men, 19 women; mean age, 76.4 years) treated with TACE over a 6-month period were included in this study. For eye protective equipment, wraparound type lead glass eye wear (0.07mmPb) are used. The personal film badge dosimeter (Hp(0.07)) stuck on the left side of the cap and DOSIRIS (Hp(3)) was stuck just lateral to the left eye under lead glass to measure the occupational eye dose. We calculated the cumulative 6-month eye dose and realistic eye dose per TACE procedures. RESULTS The mean fluoroscopy time, air kerma and dose area product were 40.9 min, 2.09 Gy and 129.8 Gy cm2, respectively. The cumulative 6-month eye dose and eye dose per procedure on DOSIRIS was 1.4 mSv and 38. 9μSv, respectively. Legal cumulative 6-month eye dose and eye dose per procedure estimated on film badge was 2.4 mSv and 66.7μSv, respectively. Possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1 estimated on DOSIRIS and film badge was 514 and 300, respectively.CONCLUSION The new eye dose limit of 20mSv y-1 may be exceeded in interventional radiological physicians who do not wear protective lead glasses. Correct evaluation of the eye dose (Hp(3)) using novel direct eye dosimeter might be needed.. |
| 8. |
Masakazu Hirakawa, Y Asayama, K Ishigami, Y Ushijima, A Nishie, H Honda
, Assessment of the occupational radiation dose to eye lens of interventional physicians during transarterial chemoembolization for hepatocellular carcinoma
, 103rd RSNA Scientific Assembly and Annual Meeting, 2017.11, PURPOSE
This study aimed to estimate lens doses using film badge and electronic pocket dosimeter and to investigate correlations between occupational lens doses and patient doses during transarterial chemoembolization (TACE) for hepatocellular carcinoma.
METHOD AND MATERIALS
Fifty eight HCC cases (31 men, 27 women; mean age, 74.4 years, mean BMI, 25.5) treated with TACE (Lipiodol-TACE: 53, DEB-TACE: 5) were included in this study. The DSA machine was equipped with a 16-inch flat-panel detector. For eye lens protective equipment, the ceiling-mounted lead screen and wraparound type lead glass eyewear (0.07mmPb, calculation-based correction factor: 0.5) are used. The both film badge dosimeter (radiophotoluminescence glass dosimeter (RGDs), Hp(10 and 0.07)) and electronic pocket dosimeter(Silicon semiconductor detector, Hp(10)) were stuck on the left side of the cap to measure the maximum eye dose. Eye lens dose were estimated from measured radiation dose on both dosimeters. Additionally, dose area product (DAP), air kerma(AK) and fluoroscopy time of each TACE procedures were recorded from DSA machine.
RESULTS
The mean fluoroscopy time, AK and DAP were 38.1 min, 1.21Gy and 297.7 Gy cm2, respectively. The unprotected eye lens dose per procedure measured on film badge tended to be higher than that of pocket dosimeter (65.5μSv vs. 26.4μSv), respectively. The protected eye lens dose per procedure on film badge tended to be higher than that of pocket dosimeter (32.75μSv vs. 13.2μSv), respectively. Estimated eye dose per unit DAP on pocket dosimeter and film badge was 0.89μSvGy-1cm-2 and 2.21μSvGy-1cm-2, respectively.The current dose limit of 20 mSv /year can be reached for 305 and 610 TACE procedures /y for the operator without and with lead glass eyewear, respectively.
CONCLUSION
The current dose limit of 20 mSv /year can be reached for a few hundreds of TACE procedures /y without lead glass eyewear. Occupational eye doses from interventional radiology procedures have the potential to exceed the new ICRP equivalent dose limit, particularly if no eye lens protective equipment is always used.
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| 9. |
Masakazu Hirakawa, Kotaro Terashima, Katsumi Sakamoto, Satoru Tsuruta, Hironori Sakai, Koshi Mimori, Hiroshi Honda, A Significant and simple trial of radiation dose reduction during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma, 2017 European congress Radiology, 2017.03, OBJECTIVE This study aimed to evaluate patient radiation dose reduction, during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma (HCC) while maintaining treatment effect (TE), adverse events(AE) and the image quality (IQ), using a new our clinical trial of radiation dose reduction. MATERIALS AND METHODS Ninety HCC cases treated with DEB-TACE were included in this study. Forty five patients (30 men, 15 women; mean age, 71.6 years) were treated under normal mode(the normal group), and 45 patients (28 men, 17 women; mean age, 70.8 years) were treated under radiation reduction mode using reduction filter (0.4mmCu+1.0mmAl), half frame rate and reduction of detector dose rate (the reduction group). Dose area product (DAP), air kerma (AK) and radiation time of each digital fluoroscopy (DF) were compared between the two groups. IQ of digital subtraction angiography (DSA) and digital angiography (DA) during infusion of DEB was assessed by two blinded and independent readers on a four-rank scale. RESULTS There were no significant differences in patient's characteristics and tumor burden between the groups. The overall adverse events relating DEB-TACE did not significantly differ between the groups. Fluoroscopy time were equivalent between the groups. Compared to the normal group, in the reduction group, AK and DAP could be significantly reduced by 65.4% (2.63 Gy vs. 1.72 Gy, p |
| 10. |
Masakazu Hirakawa, Kousei Ishigami, Yasuhiro Ushijima, Akihiro Nishie, Hiroshi Honda, A clinical trial of radiation dose reduction during transarterial chemoembolization(TACE) with drug-eluting bead(DEB) for hepatocellular carcinoma
, The 102nd Scientific Assembly & Annual Meeting Radiological Society of North America, 2016.12, OBJECTIVE This study aimed to evaluate patient radiation dose reduction, during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma (HCC) while maintaining treatment effect (TE), adverse events(AE) and the image quality (IQ), using a new our clinical trial of radiation dose reduction. MATERIALS AND METHODS Eighty five HCC cases treated with DEB-TACE were included in this study. Forty five patients (30 men, 15 women; mean age, 71.6 years) were treated under normal mode(the normal group), and 40 patients (25 men, 15 women; mean age, 69.6 years) were treated under radiation reduction mode using reduction filter, lower frame rate and etc (the reduction group). Dose area product (DAP), air kerma (AK) and radiation time of each digital fluoroscopy (DF) were compared between the two groups. IQ of digital subtraction angiography (DSA) and digital angiography (DA) during infusion of DEB was assessed by two blinded and independent readers on a four-rank scale. RESULTS There were no significant differences in patient's characteristics and tumor burden between the groups. The overall adverse events relating DEB-TACE did not significantly differ between the groups. Fluoroscopy time were equivalent between the groups. Compared to the normal group, in the reduction group, AK and DAP could be significantly reduced by 64.2% (2.63 Gy vs. 1.64 Gy, p |
| 11. |
Masakazu Hirakawa, Keishi Sugimachi, Koshi Mimori, Hiroshi Honda, Beyond “Simple” B-TACE: Combined Conventional and B-TACE Can Be Superior to Simple B-TACE?, JSIR, ISIR & APCIO 2015 , 2015.05. |
| 12. |
Masakazu Hirakawa, Keishi Sugimachi, Koshi Mimori, Hiroshi Honda, Microballoon-occluded transarterial chemoembolization (B-TACE) using Miriplatin for HCCCan B-TACE enhance the local control ?, JSIR, ISIR & APCIO 2015, 2015.05. |
| 13. |
Masakazu Hirakawa, Noriaki Wada, Hidenari Hirata, Kotaro Terashima, Katsumi Sakamoto, Kimitaka Miyajima, Satoru Tsuruta, Hironori Sakai, Koshi Mimori, Hiroshi Honda, A clinical trial of radiation dose reduction during transarterial chemoembolization(TACE) with drug-eluting bead(DEB) for hepatocellular carcinoma
, 第75回日本医学放射線学会総会, 2016.04. |
| 14. |
Initial Result of TACE with Epirubicin loaded drug-eluting beads for hypervascular liver tumor
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| 15. |
Masakazu Hirakawa, Kimitaka Miyajima, Keishi Sugimachi, Satoru Tsuruta, hironori Sakai, Koshi Mimori, Hiroshi Honda, Significant efficacy of new microballoon-occluded transarterial chemoembolization with miriplatin for hepatocellular carcinoma
: a retrospective comparison of conventional TACE with epirubicin
, 100th annual meeting Radiological Society of North America, 2014.11, Objective: This study aimed to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) with miriplatin (MPT) and those of TACE with epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Sixty-five HCC cases were treated with TACE using EPIR or MPT. Forty patients (25 men, 15 women; mean age, 73.4 years) were treated using B-TACE with MPT (the MPT-B-TACE group), and 25 patients (15 men, 10 women; mean age, 72.2 years) were treated using TACE with EPIR (the EPIR-TACE group). The local control rates (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to local recurrence (Kaplan-Meier and log-rank tests), and adverse events (AEs) were evaluated. Statistical analyses were conducted to evaluate the relationship between the patient’s characteristics and local recurrence after MPT-B-TACE using Pearson's Chi-squared test. Multivariate logistic regression analysis was also performed.
RESULTS: There were no significant differences in patient’s characteristics between the groups. The overall AE incidence did not significantly differ between the groups. According to the mRECIST, the objective response rate including complete and partial responses, in the MPT-B-TACE group (92%) was significantly higher than that in the EPIR-TACE group (76%). Overall, local recurrences in the MPT-B-TACE group were significantly lower than in the EPIR-TACE group (p Local recurrence after MPT-B-TACE was recognized in the 35% patients in the follow-up periods. Tumor size larger than 2cm and tumor number more than three HCCs were significant key factors in the local recurrence after MPT-B-TACE.
CONCLUSION
MPT-B-TACE was associated with a higher objective response rate and lower local recurrence rate than EPIR-TACE, and both showed similar adverse effects. Tumor size larger than 2cm and tumor number more than three HCCs were risk factors of the local recurrence after MPT-B-TACE.
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| 16. |
Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Kimitaka Miyajima, Asayama Yoshiki, Akihiro Nishie, Hiroshi Honda, Local control effects of microballoon-occluded transarterial chemoembolization using miriplatin
for hepatocellular carcinoma : a retrospective comparison of TACE using epirubicin
, The 11th Asia Pacific Congress of Cardiovascular and Interventional Radiology , 2014.05, Objective: The aim of this study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).MATERIALS AND METHODS: 55 HCC cases were treated with TACE using EPIR or MPT. 30 patients (MPT-B-TACE group: 20 men, 10 women; mean age 74.4years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan-Meier and log-rank test) and adverse events (AEs)were evaluated. RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child-Pugh class, and tumor size among each group. The rate of tumor multiplicity for the EPI-TACE group tended to be higher than those for the MPT-B-TACE group. Overall incidence of AEs was not significantly different between each group. According to the mRECIST criteria, the objective response rate, including complete response and partial response, in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p =0.0065). Excluding multiple HCC cases, also, the local recurrence in the MP T-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.0015).CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin.. |
| 17. |
Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization (TACE) with miriplatin and TACE with epirubicin for hepatocellular carcinoma
, The 73rd Annual Meeting of the Japan Radiological Society, 2014.04, OBJECTIVE
This study aimed to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) with miriplatin (MPT) and those of TACE with epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Fifty-five HCC cases were treated with TACE using EPIR or MPT. Thirty patients (20 men, 10 women; mean age, 74.4 years) were treated using B-TACE with MPT (the MPT-B-TACE group), and 25 patients (15 men, 10 women; mean age, 72.2 years) were treated using TACE with EPIR (the EPIR-TACE group). The local control rates (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failures (Kaplan-Meier and log-rank tests), and adverse events (AEs) were evaluated.
RESULTS
There were no significant differences in gender, age, chronic liver disease etiology, Child-Pugh class, and tumor size between the groups. The tumor multiplicity rate of the EPIR-TACE group was higher than that of the MPT-B-TACE group. The overall AE incidence did not significantly differ between the groups. According to the mRECIST, the objective response rate including complete and partial responses, in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%). Overall, local recurrences in the MPT-B-TACE group were significantly lower than in the EPIR-TACE group (p CONCLUSION
MPT-B-TACE was associated with a higher objective response rate and lower local recurrence rate than EPIR-TACE, and both showed similar adverse effects.
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| 18. |
Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Kimitaka Miyajima, Yoshiki Asayama, Akihiro Nishie, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization using miriplatin and TACE using epirubicin for hepatocellular carcinoma: a retrospective study of 50cases
, The Society of Interventional Radiology will hold its 39th Annual Scientific Meeting , 2014.03, PURPOSE: The aim of this retrospective study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Between January 2012 and 2013, 50 HCC cases were treated with TACE using EPIR or MPT. 25 patients (MPT-B-TACE group: 18 men, 7 women; mean age 74.8 ±1.8 years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2 ±1.7 years) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan–Meier and log–rank test) and adverse events (AEs) were evaluated (CTACAE 3.0).
RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child–Pugh class, and tumor size among the two groups. The rate of tumor multiplicity for the EPI-TACE group tended to be higher than those for the MPT-B-TACE group.
No serious adverse events were observed in either group. Overall incidence adverse events was not significantly different between the MPT-B-TACE group (64%) and the EPIR-TACE group (68%, p=0.575). According to the mRECIST criteria, the objective response rate, including complete response (CR) and partial response (PR), in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p=0.0065). Excluding multiple HCC cases, also, the local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.0015).
CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin.
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| 19. |
Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Asayama Yoshiki, Akihiro Nishie, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization using miriplatin and TACE using epirubicin for hepatocellular carcinoma, 26th EUROPEAN CONGRESS OF RADIOLOGY, 2014.03, PURPOSE: The aim of this retrospective study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Between January 2012 and January 2013, 39 HCC cases were treated with TACE using EPIR or MPT. 14 patients (MPT-B-TACE group: 9 men, 5 women; mean age 70.4 ±2.0 years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2 ±1.7 years) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan–Meier and log–rank test) and adverse events (AEs) were evaluated (CTACAE 3.0).
RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child–Pugh class, and tumor size among the two groups. The rate of Tumor multiplicity and selective TACE procedure for the EPI-TACE group was significantly higher than those for the MPT-B-TACE group (PNo serious adverse events were observed in either group. Overall incidence adverse events was not significantly different between the MPT-B-TACE group (50%) and the EPIR-TACE group (49%, p=0.575). According to the mRECIST criteria, the objective response rate, including complete response (CR) and partial response (PR), in the MPT-B-TACE group (92.9%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p=0.05). Excluding multiple HCC cases, also, the local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.04).
CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin.
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| 20. |
A case of renal angiomyolipoma treated by Microballoon-occluded transarterial embolization . |
| 21. |
Balloon-occluded Transarterial Chemoembolization with Miriplatin for Hepatocellular Carcinoma: Preliminary Clinical Experience. |
| 22. |
Analysis of the Response and Prognostic Factors after Cisplatin-based Transcatheter Arterial Chemoembolization along with systemic chemotherapy with Gemcitabine in the palliative Treatment of Unresectable intrahepatic Cholangiocarcinoma . |
| 23. |
平川 雅和, 坂本 勝美, 渥美 和重, 西江 昭弘, 浅山 良樹, 本田 浩, Analysis of the response and prognostic factors after cisplatin-based transcatheter arterial chemoembolization along with systemic chemotherapy with gemcitabine in the palliative treatment of unresectable intrahepatic cholangiocarcinoma
, European congress of Radiology , 2013.03, PURPOSE: To evaluate the effectiveness of cisplatin-based transcatheter arterial chemoembolization (TACE) along with systemic chemotherapy with gemcitabine in the palliative treatment of unresectable intrahepatic cholangiocarcinoma (ICC), and to identify factors affecting clinical outcome.
MATERIALS AND METHODS: The present study was approved by the institutional review board, and written informed consent was obtained from all patients.
Between 2007 and 2011, 13 patients (5 men, 8 women; mean age 70.4 ±2.0 years) with unresectable ICC underwent cisplatin-based TACE alongside systemic chemotherapy with gemcitabine. Mean tumor size was 9.8 ± 0.7 cm (range, 6.7–15 cm).The adverse effects (AEs), survival rate and prognostic factors of patient survival were evaluated.
RESULTS: The mean TACE sessions and cycles of systemic chemotherapy were 3.5 (range: 1-7) and 6.2 (range: 4 -11), respectively. Combined TACE and systemic chemotherapy were followed by few Grade 3 hematological AEs, without G4 AEs, according to CTACAE 3.0. No deaths and no acute liver failure occurred after TACE. According to the RECIST criteria, 23% (3/13) of patients achieved partial response and 46% (6/13) stabilization of disease. The Kaplan- Meier survival analysis showed that the median overall survival and median progression-free survival were 14 [95%CI: 9-16] and 8 [95%CI: 4-9] months, respectively. Results from multivariable Cox regression analyses confirmed that tumor number (hazard ratio [HR], 8.33; P = .004) and Child-Pugh class (HR, 5.34; P = .02) were the independent factors associated with patient survival duration.
CONCLUSION: Cisplatin-based TACE along with systemic chemotherapy with gemcitabine is a safe and effective treatment for patients with unresectable ICC. Multiple tumors and Child-Pugh class B were poor prognostic factors for determining the patient survival period after treatment for unresectable ICC.
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| 24. |
Efficacy of Cisplatin-based Transcatheter Arterial Chemoembolization along with systemic chemotherapy with Gemcitabine in the Treatment of Unresectable intrahepatic Cholangiocarcinoma . |
| 25. |
Efficacy of Preoperative Transcatheter Arterial Chemoembolization Along With Systemic Chemotherapy in the Treatment of Unresectable Hepatoblastoma in Children. |
| 26. |
Efficacy of Preoperative Transcatheter Arterial Chemoembolization Along With Systemic Chemotherapy in the Treatment of Unresectable Hepatoblastoma in Children. |
