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. 2014 Feb;26(1):124-31.
doi: 10.3978/j.issn.1000-9604.2014.02.11.

A comparative study between Embosphere(®) and conventional transcatheter arterial chemoembolization for treatment of unresectable liver metastasis from GIST

Guang Cao  1 , Xu Zhu  1 , Jian Li  1 , Lin Shen  1 , Renjie Yang  1 , Hui Chen  1 , Xiaodong Wang  1 , Song Gao  1 , Haifeng Xu  1 , Linzhong Zhu  1 , Peng Liu  1 , Jianhai Guo  1
Affiliations

A comparative study between Embosphere(®) and conventional transcatheter arterial chemoembolization for treatment of unresectable liver metastasis from GIST

Guang Cao et al. Chin J Cancer Res. 2014 Feb.

Abstract

Objective: Transcatheter arterial chemoembolization (TACE) is a standard treatment for hepatocellular carcinoma (HCC) and/or some unresectable liver metastasis tumors. Hypervascular liver metastatic lesions such as metastasis from gastrointestinal stromal tumor (GIST) are an indication for transcatheter arterial embolization (TAE). The purpose of this study was to evaluate the efficacy and safety of Embosphere(®)-TAE (Embo-TAE) in comparison with conventional TACE (cTACE) for the treatment of liver metastasis from GIST.

Methods: A total of 45 patients who underwent TACE between Aug 2008 and Feb 2013 were enrolled. Patients with GIST who underwent TAE with Embosphere(®) (n=19) were compared with controls who received cTACE (n=26). The primary end points were treatment response and treatment-related adverse events. The secondary end points were progression-free survival (PFS) and overall survival (OS).

Results: The treatment response of Embo-TAE group was significantly higher than that of the cTACE group (P<0.001). The PFS was significantly better in the Embosphere(®)-group than in the cTACE group (56.6 and 42.1 weeks, respectively; P=0.003). However, there was no statistically significant difference in liver toxicity between the two groups (P>0.05). The median OS in the Embo-TAE group was longer than that in the cTACE group (74.0 weeks, 95% CI: 68.2-79.8 vs. 61.7 weeks, 95% CI: 56.2-67.2 weeks) (unadjusted P=0.045). The use of Embo-TAE significantly reduced the risk of death in patients with GIST with liver metastases according to the Cox proportional hazards regression model [hazard ratio (HR): 0.149; 95% CI: 0.064-0.475].

Conclusions: TAE with Embosphere(®) showed better treatment response and delayed tumor progression compared with cTACE. There was no significant difference in treatment-related hepatic toxicities. Embo-TAE thus appears to be a feasible and promising approach in the treatment of liver metastasis from GIST.

Keywords: Transcatheter arterial chemoembolization (TACE); embolization; gastrointestinal stromal tumor (GIST).

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Figures

Figure 1
Figure 1
PFS curve. PFS, progression-free survival.
Figure 2
Figure 2
OS curve. OS, overall survival.
Figure 3
Figure 3
A lesion located in Segment IV before and after Embo-TAE. A complete necrosis was achieved with no enhancement observed in the tumor site. Embo-TAE, Embosphere®-transcatheter arterial embolization.
Figure 4
Figure 4
Two nodular GIST metastatic lesions from the stomach treated by cTACE. There is lipiodol accumulation in the tumor with no obvious enhancement observed indicating a CR in the liver. GIST, gastrointestinal stromal tumor; cTACE, conventional transcatheter arterial chemoembolization; CR, complete response.
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