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Transarterial chemoembolisation: effect of selectivity on tolerance, tumour response and survival

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Aims To compare selective and non-selective TACE techniques in the treatment of HCC with a special emphasis on clinical and liver tolerance, tumour response and survival. Methods 184 patients with advanced HCC were retrospectively included. Three different TACE techniques were compared: non selective lipiodol-chemotherapy + non selective embolisation (TACE-technique group 1), non selective lipiodol-chemotherapy + selective embolisation (group 2), and selective lipiodol-chemotherapy + selective embolisation (group 3). Results In multivariate analysis TACE-technique group is an independently significant prognostic factor for poor clinical tolerance, poor liver tolerance and tumour response. The rate of patients with poor clinical tolerance was lower in group 3 (27.0%) than in groups 1 (64.1%, p < 10−3) or 2 (66.7%, p < 10−3). The rate of patients with poor liver tolerance was higher in group 2 (34.0%) than in groups 1 (17.6%, p = 0.050) or 3 (6.9%, p = 0.011). The rate of patients with tumour response was higher when embolisation was selective versus non-selective, i.e., group 2 + 3 (78.7%) versus group 1 (62.5%, p = 0.054). Overall survival was not significantly different between the three groups (p = 0.383). Conclusion Both selective techniques resulted in better tumour response. As for improving tolerance, our study suggests that the main technical factor is the use of selective lipiodol-chemotherapy injection.

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https://hal.univ-angers.fr/hal-03267634
Contributeur : Okina Université d'Angers <>
Soumis le : mardi 22 juin 2021 - 15:27:28
Dernière modification le : mardi 13 juillet 2021 - 03:19:11

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Antoine Bouvier, Violaine Ozenne, Christophe Aubé, Jérôme Boursier, Marie Vullierme, et al.. Transarterial chemoembolisation: effect of selectivity on tolerance, tumour response and survival. European Radiology, Springer Verlag, 2011, 21 (8), pp.1719 - 1726. ⟨10.1007/s00330-011-2118-2⟩. ⟨hal-03267634⟩

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