Hepatocellular Carcinoma: Initial Tumour Response After Short-term and Long-interval Chemoembolization with Drug-eluting Beads Using Modified RECIST

Objective: The aim of this study was to evaluate the initial tumour response after one, respectively, two transarterial chemoembolizations (TACE) with drug-eluting (DC) beads in patients with hepatocellular carcinoma (HCC).

Methods: A total of 26 patients with clinically approved HCC underwent one or two TACE with DC Beads within 6 weeks and were evaluated after 12 weeks by MRI or computed tomography on the basis of the modified Response Evaluation Criteria in the Solid Tumours guidelines for HCC. For improved comparability of both groups, 16 patients were matched in terms of Child-Pugh classification, Barcelona classification of liver cancer, age and sex.

Results: The overall tumour response showed progressive disease in 11% and an objective response in 89% for the double TACE group compared with progressive disease in 29.5%, objective response in 34.5% and stable disease in 35% for the single TACE group. In the matched population, absolute tumour shrinkage was 61.1 ± 28.3% for the double TACE group and 14.1 ± 38.5% for the single TACE group (P<0.05).

Conclusion: This retrospective study shows significantly higher tumour shrinkage in patients who underwent two TACE within 6 weeks compared with patients who underwent a single intervention in terms of the initial response rate after 12 weeks. It emphasizes the use of matched populations for the evaluation of tumour response in HCC after TACE.