Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: A pilot clinical study☆

Background/Aims

Experimental studies have shown synergy between radiofrequency (RF) ablation and adjuvant chemotherapy in animal tumour models. We aimed to assess safety and efficacy of doxorubicin-eluting bead (DEB)-enhanced RF ablation in the treatment of human hepatocellular carcinoma (HCC).

Methods

Twenty patients with single HCC ranging 3.3–7.0cm (mean, 5.0cm±1.4) showing evidence of residual viable tumour after standard RF ablation underwent intraarterial DEB administration (50–125mg doxorubicin; mean, 60.2mg±21.8). Follow-up period ranged 6–20 months (mean, 12 months±5).

Results

No major complication occurred. No deterioration of liver function was observed. The volume of treatment-induced necrosis – as measured on imaging – increased from 48.1cm³±35.7 after RF ablation to 75.5cm³±52.4 after DEB administration, with an increase of 60.9%±39.0. The enhanced effect resulted in confirmed complete response (CR) of the target lesion in 12 (60%) of 20 patients. Incomplete response with persistence of <10% of initial tumour volume was observed in 6 (30%) of 20 patients, and local tumour progression in 2 (10%) of 20.

Conclusions

Intraarterial DEB administration substantially enhances the effect of RF ablation. DEB-enhanced RF ablation is safe and results in a high rate of CR in patients refractory to standard RF treatment.

Abbreviations: HCC, hepatocellular carcinoma, RF, radiofrequency, DEB, doxorubicin eluting bead, ECOG, Eastern Cooperative Oncology Group, ASA, American Society of Anesthesiologists, CT, computed tomography, MR, magnetic resonance, CR, complete response, IR, incomplete response, PD, progressive disease

Keywords: Hepatocellular carcinoma, Radiofrequency ablation, Doxorubicin