Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study

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

doi:10.2147/CMAR.S187203

Comparison of chemoembolization with CalliSpheres^® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study

Cancer Manag Res. 2020 Feb 10:12:941-956. doi: 10.2147/CMAR.S187203. eCollection 2020.

Authors

Bin Liang^#¹, Hua Xiang^#², Cong Ma³, Bin Xiong¹, Yilong Ma⁴, Chang Zhao⁴, Yuanhui Yao², Zishu Zhang³, Changyong Chen⁵, Haiping Li⁵, Qingyun Long⁶, Jun Zhou⁶, Chao Luo⁷, Huaiming Qiu⁷, Hongyao Hu⁸, Hui Zhao⁸, Guofeng Zhou¹, Chuansheng Zheng¹

Affiliations

¹ Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
² Department of Interventional Radiology, Hunan Provincial People's Hospital, Changsha, People's Republic of China.
³ Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China.
⁴ Department of Interventional Radiology, Cancer Hospital Affiliated to Guangxi Medical University, Nanning, People's Republic of China.
⁵ Department of Radiology, Xiangya Hospital General South University, Changsha, People's Republic of China.
⁶ Department of Interventional Radiology, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
⁷ Department of Radiology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, People's Republic of China.
⁸ Department of Interventional Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan, People's Republic of China.

^# Contributed equally.

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: CalliSpheres microspheres; chemoembolization; hepatocellular carcinoma; predictive factor; survival; treatment response.