Author(s)

Natália Sousa Freitas Queiroz¹, Luciana Kikuchi¹, Regis Otaviano Franca Bezerra², Regiane S. S. M. Alencar¹, Aline Lopes Chagas¹, Cláudia Megumi Tani¹, Márcio Augusto Diniz¹, Aline Cristine Barbosa Santos², Airton Mota Moreira², Manoel de Souza Rocha², Luiz Augusto Carneiro D’Albuquerque¹, Francisco César Carnevale², Flair José Carrilho¹

¹Sao Paulo Clínicas Liver Cancer Group, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
²Sao Paulo Clínicas Liver Cancer Group, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas, Department of Radiology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.

Introduction: Transarterial chemoembolization (TACE) reduces tumor growth and increases survival in patients with hepatocellular carcinoma (HCC). Drug-eluting beads (DEB) deliver slow-release chemotherapy and reduce systemic toxicity during TACE. This study correlated initial tumor response according to modified RECIST (mRECIST) criteria and 1-year survival in patients with HCC treated with TACE-DEB, and identified predictors of tumor response. Methods: Fifty-two patients with HCC received TACE-DEB loaded with doxorubicin 75 mg during a 6-month period. Tumor response was evaluated 1 month after the procedure according to mRECIST criteria. Results: Most patients were cirrhotic and etiology of liver disease was hepatitis C in 26/52 (50%). Similar numbers of patients had Barcelona Clinic Liver Cancer (BCLC) A and BCLC B disease. Most patients had one nodule (66%). Complete response (CR) was achieved in 12/52 (23%), partial response in 19/52 (37%), stable disease in 4/52 (8%) and progressive disease in 17/52 (32%). Largest HCC ≤58 mm and BCLC stage A were associated with CR. The 1-year survival was 74%, with survival rates of 95% and 56% in the BCLC A and B groups, respectively. Variables reflecting tumor extension were associated with better survival. CR according to mRECIST criteria was a predictor of better 1-year survival (100% vs. 64%, P < 0.05). Conclusion: BCLC A and CR according to mRECIST criteria predict improved 1-year survival in patients with HCC treated with TACE-DEB. Further studies are needed to evaluate other predictors of survival and to determine if tumor response predicts long-term survival.

Hepatocellular Carcinoma, mRECIST Criteria, Transarterial Chemoembolization, Overall Survival, Drug-Eluting Beads

Queiroz, N. , Kikuchi, L. , Bezerra, R. , Alencar, R. , Chagas, A. , Tani, C. , Diniz, M. , Santos, A. , Moreira, A. , Rocha, M. , D’Albuquerque, L. , Carnevale, F. and Carrilho, F. (2015) Use of Initial Modified RECIST Tumor Response Evaluation Criteria for Predicting Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization with Drug-Eluting Beads. Journal of Cancer Therapy, 6, 1115-1123. doi: 10.4236/jct.2015.613121.