<p>Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study</p>
Bin Liang, Hua Xiang, Cong Ma, Bin Xiong, Yilong Ma, Chang Zhao, Yuanhui Yao, Zishu Zhang, Changyong Chen, Haiping Li, Qingyun Long, Jun Zhou, Chao Luo, Huaiming Qiu, Hongyao Hu, Hui Zhao, Guofeng Zhou, Chuansheng Zheng
Abstract
Purpose: This study aimed to compare the efficacy and safety between transarterial chemoembolization (TACE) with CalliSpheres ® microspheres (CSM-TACE) and conventional TACE (cTACE) in patients with hepatocellular carcinoma (HCC). Patients and Methods: Three hundred and thirty-five HCC patients receiving CSM-TACE or cTACE were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into CSM-TACE group and cTACE group accordingly. Complete response (CR), objective response (ORR) and disease control response (DCR) was assessed according to mRECIST criteria at 1 month (M1), 3 months(M3) and 6 months(M6) after treatment. Progression-free survival (PFS) and overall survival (OS) were assessed. Liver function indexes and adverse events (AEs) were also evaluated. Results: CR at M3 ( P =0.020) and ORR at M1 ( P < 0.001), M3 ( P < 0.001) and M6 ( P =0.017) after treatment were significantly higher in the CSM-TACE compared with cTACE group. DCRs, PFS (25.3 months vs 24.2 months, P =0.503) and OS (27.8 months vs 25.3 months, P =0.203) were similar between the two groups. CSM-TACE was independently correlated with higher ORR at M1 ( P =0.002) and longer OS ( P =0.023). Abnormal alkaline phosphatase (ALP) ( P =0.049) was independently associated with lower ORR at M3, and history of alcohol intake ( P =0.019) and largest nodule size ≥ 7 cm ( P =0.015) independently correlated with lower ORR at M6 ( P =0.015). Largest nodule size ≥ 7 cm ( P =0.029) and abnormal albumin (ALB) ( P =0.046) were independently associated with shorter PFS. Child-Pugh stage B/C ( P =0.023), abnormal ALB ( P =0.001), ALP ( P =0.008) and alpha-fetoprotein (AFP) ( P =0.005) were independently associated with shorter OS. Most liver function indexes and AEs were similar between the two groups ( P > 0.05), except that ALP ( P =0.005), total bilirubin ( P =0.031), pain during procedure ( P =0.034) and occurrence of fever post(treatment ( P =0.017) were significantly elevated in the CSM-TACE compared with cTACE group. Conclusion: CSM-TACE presents with a better treatment response and similar survival profile compared with cTACE in HCC patients. Keywords: chemoembolization, CalliSpheres microspheres, hepatocellular carcinoma, treatment response, survival, predictive factor