Trans-arterial chemoembolization with doxorubicin-eluting particles versus conventional trans-arterial chemoembolization in unresectable hepatocellular carcinoma: A study of effectiveness, safety and costs.

Autores de IIS La Fe

• Juan Eduardo Megías Vericat

  Autor

• Raúl García Marcos

  Autor

• Eduardo López Briz

  Autor

• Jose Joaquin Martinez Rodrigo

  Autor

• José Luis Poveda Andrés

  Autor

Participantes ajenos a IIS La Fe

• Gómez Muñoz F
• Ramos Ruiz J

Grupos

• Farmacogenética

• Investigacion Biomédica en Imagen (GIBI 2-30)

Abstract

OBJECTIVES: To compare the effectiveness, survival and cost in patients with unresectable hepatic cell carcinoma (HCC) treated with trans-arterial chemoembolization using doxorubicin-eluting beads (DEB-TACE) versus conventional TACE (cTACE) in clinical practice. MATERIAL AND METHODS: This single-centered retrospective observational study compared 60 consecutive HCC unresectable patients: 30 were treated with DEB-TACE and 30 used cTACE. Comparisons were with chi(2) test, Student t-test, and Kaplan Meier method. RESULTS: Of the 60 patients with HCC in non-curative stage, baseline characteristics were similar for both groups of treatment, and of these we observed lower survival in male patients and those who had hepatitis C virus (p=0.014 and p=0.003, respectively). No statistically significant differences were observed as a function of treatment employed with respect to overall survival (OS) at 5 years (29.99 months; 95%CI: 21.38-38.60 versus 30.67 months; 95%CI:22.65-38.70; p=0.626) and progression free survival (PFS) median of 11.57 months (95%CI: 0.97-22.18) versus 12.80 months (95%CI:0.00-32.37; p=0.618). The median length of hospital admission were 2.6 and 5.4 days (p<0.001) for DEB(-)TACE and cTACE, respectively. Toxicities grade 2-4 were higher in cTACE group (54 versus 31; p<0.001). The cost of the treatment was 1581 euro for DEB(-)TACE and 514.63 euro for cTACE. The overall mean cost of intervention was 3134 euro and 3694.35 euro, respectively (p=0.173). CONCLUSIONS: Chemoembolization in patients with unresectable HCC achieved OS close to 30 months at 5 years, independent of the technique employed. Similar overall costs but better tolerance of the DEB-TACE justified the higher costs of the procedure.

Keywords

• Carcinoma hepatocelular irresecable; Cost; Coste; Doxorubicin-eluting beads; Efectividad; Effectiveness; Particulas liberadoras de doxorrubicina; Quimioembolizacion transarterial; Survival; Toxicidad; Toxicity; Trans-arterial chemoembolization; Unresectable hepatic cell carcinoma; supervivencia