1.Transarterial Chemoembolization Using Gelatin Sponges or Microspheres Plus Lipiodol-Doxorubicin versus Doxorubicin-Loaded Beads for the Treatment of Hepatocellular Carcinoma.
Yi Sheng LIU ; Ming Ching OU ; Yi Shan TSAI ; Xi Zhang LIN ; Chien Kuo WANG ; Hong Ming TSAI ; Ming Tsung CHUANG
Korean Journal of Radiology 2015;16(1):125-132
OBJECTIVE: To retrospectively compare treatment of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) using gelatin sponges or microspheres plus lipiodol-doxorubicin vs. doxorubicin-loaded drug-eluting beads (DEB). MATERIALS AND METHODS: A total of 158 patients with HCC received TACE from November 2010 to November 2011 were enrolled in this study, including 64 (40.5%) received TACE with lipiodol-doxorubicin and gelatin sponges (group A), 41 (25.9%) received TACE with lipiodol-doxorubicin and microspheres (group B), and 53 (33.5%) received TACE with doxorubicin-loaded DEB (group C). Tumor response and adverse events (AEs) were evaluated. RESULTS: No significant difference was found at baseline among the three groups. The doxorubicin dosage in group C was significantly (p < 0.001) higher compared to the dose used in groups A or B (median, 50 mg vs. 31 mg or 25 mg). Significantly (p < 0.001) more patients in group C achieved complete response compared to those in groups A or B (32.1% vs. 6.3% or 2.4%). Significantly (p < 0.001) less patients in group C had progressive disease compared to those in groups A or B (34.0% vs. 57.8% or 68.3%). Minor AEs were more common in groups A and B compared to group C, with rates of 54.7%, 34.1%, and 5.7%, respectively. CONCLUSION: In patients with HCC, TACE with DEB offers better safety and efficacy profiles compared to either TACE with gelatin sponges or TACE with microspheres.
Abdominal Pain/etiology
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Adult
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Aged
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Antibiotics, Antineoplastic/*administration & dosage/adverse effects
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Carcinoma, Hepatocellular/*drug therapy/mortality
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Chemoembolization, Therapeutic
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Disease-Free Survival
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Doxorubicin/*administration & dosage/adverse effects
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Drug Carriers/*chemistry
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Ethiodized Oil/chemistry
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Female
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Fever/etiology
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Follow-Up Studies
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Gelatin/chemistry
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Humans
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Kaplan-Meier Estimate
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Liver Neoplasms/*drug therapy/mortality
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Male
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Microspheres
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Middle Aged
;
Retrospective Studies
2.Comparison of the Efficacy of Two Microsphere Embolic Agents for Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma Patients
Shao-Hua LEE ; Chia-Ying LIN ; Ya-Chun HSU ; Yi-Sheng LIU ; Ming-Tsung CHUANG ; Ming-Ching OU
Cancer Research and Treatment 2020;52(1):24-30
Purpose:
Transarterial chemoembolization (TACE) delivers cytotoxic drugs intra-arterially and induces ischemic necrosis by arterial embolization. Embolization is achieved using a variety of agents that differ widely in particle size and range, deformation, and in vivo arterial distribution. The clinical significance of these differences has not been thoroughly characterized. The present study is to compare the efficacy of Embosphere and Embozene microspheres in TACE therapy for hepatocellular carcinoma.
Materials and Methods:
This retrospective study includes 108 hepatocellular carcinoma (HCC) patients who received TACE/doxorubicin with Embozene (70 patients) or Embosphere (38 patients) at a single medical center. Patient outcomes, including liver function, tumor size, tumor response, and complications after treatment, were analyzed. The change in total target lesion size and tumor response was evaluated according to embolization agent and clinical characteristics.
Results:
The postoperative glutamate oxaloacetate transaminase (mean, 194.5 vs. 147.5; p=0.032) and bilirubin (mean, 1.11 mg/dL vs. 0.73 mg/dL; p=0.016) were higher among patients treated with Embozene, the decrease in the number (55.86±25.55% vs. 41.81±38.51%, p=0.027) and size (56.37±25.91 mm vs. 43.44±37.89 mm, p=0.001) of liver tumors relative to baseline was greater in these patients than in those treated with Embosphere. These greater antitumor effects were achieved using lower doses of doxorubicin than for treatment with Embozene. Minor complications were more common among patients treated with Embosphere than with Embozene.
Conclusion
These results suggest that Embozene is more efficacious than Embosphere for HCC treatment using TACE/doxorubicin.
3.Maintenance of pegylated liposomal doxorubicin/carboplatin in patients with advanced ovarian cancer: randomized study of an Asian Gynecologic Oncology Group
Chyong-Huey LAI ; Elizabeth VALLIKAD ; Hao LIN ; Lan-Yan YANG ; Shih-Ming JUNG ; Hsueh-Erh LIU ; Yu-Che OU ; Hung-Hsueh CHOU ; Cheng-Tao LIN ; Huei-Jean HUANG ; Kuan-Gen HUANG ; Jiantai QIU ; Yao-Ching HUNG ; Tzu-I WU ; Wei-Yang CHANG ; Kien-Thiam TAN ; Chiao-Yun LIN ; Angel CHAO ; Chee-Jen CHANG
Journal of Gynecologic Oncology 2020;31(1):e5-
Objectives:
An Asian Gynecologic Oncology Group phase III randomized trial was conducted to determine whether maintenance chemotherapy could improve progression-free survival (PFS) in stages III/IV ovarian cancer.
Methods:
Between 2007 and 2014, 45 newly-diagnosed ovarian cancer patients were enrolled after complete remission and randomized (1:1) to arm A (4-weekly carboplatin area under the curve 4 and pegylated liposomal doxorubicin [PLD] 30 mg/m2, n=24) for 6 cycles or arm B (observation, n=21). The primary end-point was PFS. A post hoc translational study was conducted to deep sequence BRCA/homologous recombination deficiency (HRD) genes, because BRCA/HRD mutations (BRCA/HRDm) are known to be associated with better prognosis.
Results:
Enrollment was slow, accrual was closed when 7+ years had passed. With a medianfollow-up of 88.9 months, the median PFS was significantly better in arm A (55.5 months) than arm B (9.2 months) (hazard ratio [HR]=0.40; 95% confidence interval [CI]=0.19–0.87; p=0.020), yet the median overall survival was not significantly different in arm A (not reached) than arm B (95.1 months) (p=0.148). Overall grade 3/4 adverse events were more frequent in arm A than arm B (60.9% vs 0.0%) (p<0.001). Quality of life was generally not significantly different. Distribution of BRCA1/2m or BRCA/HRDm was not significantly biased between the two arms. Wild-type BRCAon-HRD subgroup seemed to fare better with maintenance therapy (HR=0.35; 95% CI=0.11–1.18; p=0.091).
Conclusions
Despite limitations in small sample size, it suggests that maintenance carboplatin-PLD chemotherapy could improve PFS in advanced ovarian cancer.
4.Maintenance of pegylated liposomal doxorubicin/carboplatin in patients with advanced ovarian cancer: randomized study of an Asian Gynecologic Oncology Group
Chyong Huey LAI ; Elizabeth VALLIKAD ; Hao LIN ; Lan Yan YANG ; Shih Ming JUNG ; Hsueh Erh LIU ; Yu Che OU ; Hung Hsueh CHOU ; Cheng Tao LIN ; Huei Jean HUANG ; Kuan Gen HUANG ; Jiantai QIU ; Yao Ching HUNG ; Tzu I WU ; Wei Yang CHANG ; Kien Thiam TAN ; Chiao Yun LIN ; Angel CHAO ; Chee Jen CHANG
Journal of Gynecologic Oncology 2020;31(1):5-