Korean J Hepatol.  2011 Mar;17(1):51-60. 10.3350/kjhep.2011.17.1.51.

Optimal technique and response of doxorubicin beads in hepatocellular cancer: bead size and dose

• Martin R
• Irurzun J
• Munchart J
• Trofimov I
• Scupchenko A
• Tatum C
• Narayanan

• KMID: 1105514
• DOI: http://doi.org/10.3350/kjhep.2011.17.1.51

Abstract

BACKGROUND/AIMS
It has been shown that the drug-eluting beads loaded with doxorubicin (DEBDOX) are effective for the treatment of hepatocellular carcinoma (HCC). However, the optimal safety and efficacy still remain to be established by using various bead sizes, doxorubicin doses, and the degree of stasis.The aim of this study was to determine the optimal safety and efficacy of DEBDOX in the treatment of HCC.
METHODS
Analysis of a 503-patient prospective, multicenter, multinational Bead Registry Database from 2007 to 2010 identified 206 patients who had been treated for HCC with DEBDOX. Primary endpoints were to compare safety, tolerance, response rates, and overall survival based on bead size (100-300, 300-500, 500-700, and 700-900 microm), number of vials, doxorubicin dose, and degree of stasis.
RESULTS
In total, 206 patients underwent 343 treatments. The use of all four bead sizes was similar based on Child-Pugh class and Okuda stage, with a significantly higher use (50%) of beads of size 100-300 microm in patients with portal vein thrombosis (P=0.05). Significant differences were seen for the number of median treatments, median doxorubicin dose, lobar infusion), and degree of complete stasis. The rate of adverse events was higher for larger beads than for smaller beads (28% vs. 16%; P=0.02).
CONCLUSIONS
Bead size and dose may vary according to disease distribution. Smaller beads offer the opportunity for repeated treatments, a larger cumulative dose delivery, a lesser degree of complete stasis, and fewer adverse events.

Keyword

Drug eluting beads; Doxorubicin; Hepatocellular carcinoma; Chemoembolization; Adverse events

MeSH Terms

Adult
Aged
Aged, 80 and over
Antibiotics, Antineoplastic/*administration & dosage/adverse effects
Carcinoma, Hepatocellular/*drug therapy/mortality
Dose-Response Relationship, Drug
Doxorubicin/*administration & dosage/adverse effects
Drug Carriers/*chemistry
Female
Humans
Liver Neoplasms/*drug therapy/mortality
Male
Middle Aged
Particle Size
Prospective Studies
Severity of Illness Index