Use of Ethanol in the Trans-Arterial Lipiodol Embolization (TAELE) of Intermediated-Stage HCC: Is This Safer than Conventional Trans-Arterial Chemo-Embolization (c-TACE)?

• Published in: PloS one 2015-06, Vol.10 (6), p.e0129573
• Main Authors: Somma, Francesco, D'Angelo, Roberto, Serra, Nicola, Gatta, Gianluca, Grassi, Roberto, Fiore, Francesco
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Anticancer properties; Cancer therapies; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic - adverse effects; Chemoembolization, Therapeutic - methods; Computed tomography; Embolization; Epirubicin; Epirubicin - administration & dosage; Epirubicin - therapeutic use; Ethanol; Ethanol - administration & dosage; Ethanol - therapeutic use; Ethiodized Oil - administration & dosage; Ethiodized Oil - therapeutic use; Female; Hepatology; Humans; Life assessment; Liver cancer; Liver Neoplasms - therapy; Male; Medicine; Middle Aged; Patients; Retrospective Studies; Surgery; Survival; Survival analysis; Toxicity; Transplants & implants; Treatment Outcome; Tumors; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0129573

To evaluate safety and efficacy of Trans-Arterial Ethanol-Lipiodol Embolization (TAELE) compared with conventional Trans-Arterial Chemo-Embolization (cTACE) in the treatment of small intermediate-HCC (BCLC-Stage B). A random sample of 87 patients (37.93% male; 62.07% female; age range, 36-86 years) with documented small intermediate-HCC and treated with TAELE (mixture 1:1 of Ethanol and Lipiodol) or cTACE (mixture of 50mg-Epirubicin and 5cc-Lipiodol) were retrospectively studied in an institutional review board approved protocol. The two procedures were compared with χ2-test, χ2-test with Yates correction, McNemar's exact test, ANOVA test and log-rank test. TAELE and cTACE therapies were performed in 45 and 42 patients, respectively. Thirty days after the procedure, a Multi-Detector Computed Tomography (MDCT) showed no significant difference in the number of patients with partial and complete response between the two groups (p-value = 0.958), according to mRECIST. Contrary, significant differences were found in tumor-devascularization, lesion-reduction and post-embolization syndrome occurrence (p-value = 0.0004, p-value = 0.0003 and p-value = 0.009, respectively). Similar survival was observed during 36-month follow-up (p-value = 0.884). Compared to cTACE, TAELE showed a better toxicity profile with similar 36-month survival and similar one-month anti-tumor effects, which makes it better tolerated by patients, especially in case of more than one treatment.