Nút hóa chất động mạch gan kinh điển sau nút hóa chất với hạn tải thuốc trong điều trị ung thư gan nguyên phát

Sequential transcatheter arterial chemoembolization and chemoembolization with drug-eluting beads for the treatment of hepatocellular carcinoma

SUMMARY

Conventional transcatheter arterial chemoembolization (cTACE) and chemoembolization with drug-eluting beads (DEB-TACE) are increasingly being performed interchangeably in many centers throughout the world. The introduction of DEB-TACE brought more technical standardization and reduction of TACE related toxicity. However, there are several problems when perform DEB-TACE technique (requires super-selective embolization of the tumors, rate of abscess formation after DEB-TACE is higher than after conventional TACE,…). At our center, Multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI) are usually used to evaluate treatment response after cTACE or DEB-TACE with the use of dynamic radiologic response evaluation criteria mRECIST. MDCT also show that the residual tumors are fed by several alternative arteries that are difficult or unable to be embolized superselectively.

Therefore, at our department, we decided to use cTACE with the tumors which have enhancement on MDCT of MRI after DEB-TACE to reduce the risk of severe complications. The purpose of this article is to evaluate the efficiency and safety of this combined technique (cTACE after DEB-TACE).

Key words: Hepatocellular carcinoma (HCC), conventional TACE (cTACE), drug-eluting bead TACE (DEB-TACE), combined.