Unit:
Τομέας ΚλινικοεργαστηριακόςLibrary of the School of Health Sciences
Author:
Εμμανουήλ Εμανουήλ
Dissertation committee:
Αικ. Μαλαγάρη
Original Title:
Συστήματα αξιολόγησης ανταπόκρισης στη θεραπεία συμπαγών όγκων ήπατος
Summary:
The main purpose of the study was the comparison of the systems RECIST, EASL
and WHO, and which of these three systems better represents the state of the
patient. Also we demonstrated that the use of Beads loaded with 150mg of
doxorubicin offers combine ischemic and local cytotoxic effect by maintaining
low levels of toxicity.
We identified 87 patients with confirmed unresectable HCC who were randomised
to the tumour size in two groups and subjected to two types of embolization.
The group A (41 patients) was submitted with DEB Tace, Dc Beads with
doxorubicin (33.5mg/ml suspension) while group B (43 patients) was submitted
with ischemic embolization Bead Block.
Compared the agreement between systems EASL, RECIST and WHO using thw k
statistics, where coefficient from 0.75 to 0.80 was considered satisfactory
Overall objective responce rates were higher in group A, with statistically
significant difference occurs only at 9 months (55% versus 31.7%) (p:0.04).
Disease progression at 12 months was observed in 48.6% of group A nad 78.6% of
group B (p:0.014).
The survival rates at 6,9 and 12 months were respectively 100%, 97.5% and 85.3%
for group A and 100%, 95.3% and 86% for group B, with no statistically
significant difference between the two groups. Cause of death was liver failure.
The above study shows that all three systems are reliable because they reflect
well the clinical condition after embolization, while the analysis shoed that
the EASL system is the most reliable one by taking into account the necrosis.
Also ischemia has a key role in tumour necrosis and this additionally
conributes to the local reaction of the chemothreapy. Finally it is clear that
the chemotherapeutic agent plays a significant role with beads larger than
100μm.
Keywords:
Doxorubicin, Hepatocellular carcinoma, Chemoembolization, Bead, Evaluation sysyems
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