ORLANDO, FLA. — Transcatheter arterial chemoinfusion without embolization is a safe and effective treatment in patients with unresectable stage I, II, or III hepatocellular carcinoma, and could serve as a safer alternative to transcatheter arterial chemoembolization, Mindie H. Nguyen, M.D., said at the annual meeting of the American College of Gastroenterology.
In a retrospective study of 165 patients who underwent transcatheter arterial chemoinfusion (TACI) between 1998 and 2002, the complete response rate among those with stage I, II, or III disease was about 50%, and the partial response and nonresponse rates were each about 25%. Among those with stage IV disease, complete response occurred in fewer than 15%, and partial response and nonresponse each occurred in fewer than 43%, said Dr. Nguyen of Stanford (Calif.) University.
Stage IV disease was the only predictor of nonresponse to TACI, she noted.
Patients all received chemoinfusion with cisplatin, doxorubicin, and lipiodol, and were observed overnight in the hospital. They were evaluated clinically at 2 weeks, and underwent radiologic evaluation at 3 months. Repeat TACI was conducted if residual or new tumors were detected; the average number of TACI procedures per patient was two.
The rate of serious complications among the TACI patients was 1.5%, with two patients experiencing hepatic failure. About 98% of patients required a hospital stay of less than 24 hours. Overall survival at 4 years was 66%.