A novel treatment strategy using indocyanine green for transarterial chemoembolization in BCLC stage C hepatocellular carcinoma. (8th November 2019)

• Record Type: Journal Article
• Authors: Mei, Jie; Li, Shao‐Hua; Wang, Qiao‐Xuan; Zhong, Xiao‐Ping; Lu, Liang‐He; Kan, Anna; Wei, Wei; Guo, Rong‐Ping
• Is Part Of: Cancer medicine. Volume 9:Number 1(2020)
• Page Start: 62
• Page End: 76
• Publication Date: 2019-11-08
• Subjects: BCLC stage C -- hepatocellular carcinoma -- indocyanine green -- transarterial chemoembolization -- treatment strategy; 616.994005
• DOI: 10.1002/cam4.2671
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Purpose: The aim of our study was to propose a strategy based on indocyanine green (ICG) (SBI) to provide better clinical guidelines for transarterial chemoembolization (TACE) treatments for Barcelona clinic liver cancer (BCLC) stage C hepatocellular carcinoma (HCC) patients. Materials and Methods: From October 2005 to December 2012, 112 BCLC stage C HCC patients initially treated with TACE were investigated, randomly divided into a training cohort (n = 79) and validation cohort (n = 33). In training group, the patients were grouped based on their 15 minutes ICG retention rate (ICG R15), different chemo drugs and dose of lipidol in TACE. Overall survival (OS) and progression‐free survival (PFS) were analyzed in subgroups. Strategy based on ICG was built and verified in validation group. Results: For those patients with ICG R15 values >10%, the lipiodol ≤10 mL group showed better survival than the lipiodol >10 mL group. For those patients with ICG R15 values ≤10%, the group that received triple‐drug chemotherapy treatments with lipiodol diameter ratio values between 1 and 3 showed better survival than the other group. Patients who conformed with the SBI had better survival times than those who did not conform with the SBI, in both the training cohort (median OS 10.3 vs 5.1 months; P < .001; median PFS, 3.3 vs 2.1 months; P = .006) and the validation cohort (median OS 8.9 vs 7.1 months; P = .087; median PFS, 6.6 vs 2.3 months; P < .001). Conclusions: The SBI is suitable and may provide survival benefits for TACE treatments in BCLC stage C HCC patients. Abstract : In this study, we proposed a new indocyanine green (ICG)‐based treatment strategy, which was suitable and might provide survival benefits for transarterial chemoembolization treatments in Barcelona clinic liver cancer stage C hepatocellular carcinoma patients. For those patients with ICG retention rate (ICG R15) values greater than 10%, the lipiodol dose should be reduced to no more than 10 mL, and for those patients with ICG R15 values less than 10%, maintain the LDR value between 1 and 3 and use a triple chemotherapy drug regimen.