Gouchi, Izwan (2023) Effectiveness of conventional transarterial chemo-embolization (cTACE) in comparison to drug-eluting beads transarterial chemo-embolization (DEB-TACE) for treatment of hepatocellular carcinoma in Hospital USM, Kelantan. Masters thesis, Universiti Sains Malaysia.
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Abstract
Background: Transarterial chemoembolization (TACE) is the standard treatment for stage B hepatocellular carcinoma (HCC). Currently, there are two available TACE techniques used – the conventional TACE (cTACE) and drug-eluting beads TACE (DEB-TACE). Theoretically, DEB-TACE should have a better tumour response with less systemic toxicity as compared to cTACE. The purpose of this study was to compare the treatment response and the accompanying side effects of cTACE in comparison with DEB-TACE. Methods: A total of 161 patients who underwent TACE between January 2012 until April 2022 were included in this retrospective study, where we compared HCC patients who underwent TACE with cTACE (n = 106) and DEB-TACE (n = 55). This study was conducted in Hospital Universiti Sains Malaysia (Hospital USM), Kubang Kerian, Kelantan, Malaysia. Pre- and post-TACE imaging were reviewed and the viable tumour was measured based on mRECIST criteria and assigned to its treatment response categories. The images were further evaluated to identify for side effects related to the procedure in both cTACE and DEB-TACE groups. Results: A total of 12 patients were categorized under complete response [8 patients (7.5 %) in cTACE; 4 patients (7.3 %) in DEB-TACE], 82 patients were categorized under partial treatment response [51 patients (48.1. %) in cTACE; 31 patients (56.4 %) in DEB-TACE], 21 patients were categorized under stable disease [12 patients (11.3 %) in cTACE; 9 patients (16.4 %) in DEB-TACE], and 46 patients were categorized under progressive disease [35 patients (33.0 %) in cTACE; 11 patients (20.0 %) in DEB-TACE]. Statistically, no significant difference in tumour response between cTACE and DEB-TACE (p-value of 0.342). However, higher percentage of progressive disease was observed in cTACE group as compared to DEB-TACE group. Significant difference in local side effects were observed (p-value of 0.03) as more local side effects were documented under the DEB-TACE group. The local side effects observed in our study were dilated bile ducts (1 patient), portal vein thrombosis (17 patients), and cholecystitis (9 patients). A total of 17 patients were found to develop post-embolization syndrome and 20 patients developed liver toxicity, however no significant difference (p-value > 0.05). No severe adverse events or procedure-related mortality were observed in both groups. Conclusion: No significant difference in the effectiveness of cTACE and DEB-TACE in treating HCC patients in terms of tumour response based on mRECIST criteria. However, more local side effects were observed in DEB-TACE group.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | TACE, Conventional TACE, DEB-TACE |
| Subjects: | R Medicine R Medicine > RC Internal medicine > RC254-282 Neoplasms. Tumors. Oncology (including Cancer) |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | Mr Abdul Hadi Mohammad |
| Date Deposited: | 20 May 2025 04:40 |
| Last Modified: | 25 May 2025 02:56 |
| URI: | http://eprints.usm.my/id/eprint/62251 |
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