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Pescatori LC, Galletto Pregliasco A, Derbel H, Saccenti L, Ghosn M, Blain M, Chalayea J, Luciani A, Mulé S, Amaddeo G, Kobeiter H, Tacher V. Combination of intrahepatic TARE and extrahepatic TACE to treat HCC patients with extrahepatic artery supply: A case series. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2024; 9:100042. [PMID: 39076578 PMCID: PMC11265365 DOI: 10.1016/j.redii.2024.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/24/2024] [Indexed: 07/31/2024]
Abstract
Purpose The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC). Methods Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded. Safety and tumor response were assessed at 6 months. Results Nine patients (8 men, median age 62 years [IQR: 54-72 years]) were included. Seven patients had previous treatments on the target nodule (TARE: 5; TACE: 2). The median longest axis (LA) of the lesion was 70 mm (IQR: 60-79 mm). Three patients had portal vein invasion (VP3). The EHFA originated from the right diaphragmatic artery (n = 6), the right adrenal artery (n = 2), and the left gastric artery (n = 1). The LA of the tumor portion treated with TACE was 47 mm (range: 35-64 mm). The ratio between the LA of the entire lesion and the LA treated with TACE was 1.44 (range: 1.27-1.7). One major complication occurred: acute on chronic liver failure. Median follow-up was 23 months (range: 16-29 months). Seven patients underwent further treatment: on the same lesion (n = 2), on newly appeared nodules (n = 2), and systemic treatment (n = 3). At 6-month follow-up, seven patients showed a local objective response. Time-to-progression was 13 (3.5-19) months. Conclusion The combination of TARE and extrahepatic TACE for HCC with both intrahepatic and extrahepatic arterial supplies seems feasible and safe. Further studies are needed to validate the effectiveness of these preliminary results.
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Affiliation(s)
| | | | - Haytham Derbel
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
| | - Laetitia Saccenti
- Department of Radiology, hôpital Henri-Mondor (AP-HP), Créteil, France
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
| | - Mario Ghosn
- Department of Radiology, hôpital Henri-Mondor (AP-HP), Créteil, France
| | - Maxime Blain
- Department of Radiology, hôpital Henri-Mondor (AP-HP), Créteil, France
| | - Julia Chalayea
- Department of Nuclear Medicine, hôpital Henri-Mondor (AP-HP), Créteil, France
| | - Alain Luciani
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
| | - Sebastien Mulé
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
| | - Giuliana Amaddeo
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
- Department of Hepatology, hôpital Henri-Mondor (AP-HP), Créteil, France
| | - Hicham Kobeiter
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
- Inserm IMRB U955, équipe 8, université Paris-Est Créteil, Créteil, France
| | - Vania Tacher
- Inserm IMRB U955, équipe 18, université Paris-Est Créteil, Créteil, France
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