Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment

Pi Yi Chang, Chun Chieh Huang, Chao Hung Hung, Chih Yung Yu, Ding Kwo Wu, Jen I. Hwang, Po Chin Liang, Reng Hong Wu, Wei Lun Tsai, Yih Jyh Lin, Yi Sheng Liu, Huei Lung Liang, Rheun Chuan Lee, Chien Hung Chen

Research output: Contribution to journalArticle

Abstract

Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials. Since Lencioni et al. [Cardiovasc Intervent Radiol 2012; 35: 980-985] published the first widely accepted technical recommendations on HCC embolization with DEBDOX-TACE in 2012, new studies have contributed to a better understanding of when and how to apply this new therapeutic modality, and they have yet to be incorporated into an updated guideline. Additionally, differences in the underlying liver pathology and practice of transcatheter embolization between Asian and Western populations have not been adequately addressed, and there remain significant variations in the TACE protocols adopted in different parts of the world. These mainly revolve around the number and type of chemotherapeutic agents used, type of embolic material, reliance on Lipiodol, and selectivity of catheter positioning. As a result of these issues, it has been difficult to interpret and compare results obtained from different centers in a systematic fashion. To address these concerns, we convened a panel of experts specializing in different aspects of HCC treatment to craft an updated set of recommendations that better reflect recent clinical experiences and are tailored to the use of DEBDOX-TACE in Taiwan. The conclusions of this expert panel are described in the following article.

Original languageEnglish
Pages (from-to)312-322
Number of pages11
JournalLiver Cancer
Volume7
Issue number4
DOIs
Publication statusPublished - 2018 Oct 1

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Taiwan
Doxorubicin
Hepatocellular Carcinoma
Pharmaceutical Preparations
Ethiodized Oil
Therapeutics
Microspheres
Catheters
Randomized Controlled Trials
Guidelines
Pathology
Liver
Population

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Oncology

Cite this

Chang, P. Y., Huang, C. C., Hung, C. H., Yu, C. Y., Wu, D. K., Hwang, J. I., ... Chen, C. H. (2018). Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment. Liver Cancer, 7(4), 312-322. https://doi.org/10.1159/000487608
Chang, Pi Yi ; Huang, Chun Chieh ; Hung, Chao Hung ; Yu, Chih Yung ; Wu, Ding Kwo ; Hwang, Jen I. ; Liang, Po Chin ; Wu, Reng Hong ; Tsai, Wei Lun ; Lin, Yih Jyh ; Liu, Yi Sheng ; Liang, Huei Lung ; Lee, Rheun Chuan ; Chen, Chien Hung. / Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment. In: Liver Cancer. 2018 ; Vol. 7, No. 4. pp. 312-322.
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title = "Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment",
abstract = "Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials. Since Lencioni et al. [Cardiovasc Intervent Radiol 2012; 35: 980-985] published the first widely accepted technical recommendations on HCC embolization with DEBDOX-TACE in 2012, new studies have contributed to a better understanding of when and how to apply this new therapeutic modality, and they have yet to be incorporated into an updated guideline. Additionally, differences in the underlying liver pathology and practice of transcatheter embolization between Asian and Western populations have not been adequately addressed, and there remain significant variations in the TACE protocols adopted in different parts of the world. These mainly revolve around the number and type of chemotherapeutic agents used, type of embolic material, reliance on Lipiodol, and selectivity of catheter positioning. As a result of these issues, it has been difficult to interpret and compare results obtained from different centers in a systematic fashion. To address these concerns, we convened a panel of experts specializing in different aspects of HCC treatment to craft an updated set of recommendations that better reflect recent clinical experiences and are tailored to the use of DEBDOX-TACE in Taiwan. The conclusions of this expert panel are described in the following article.",
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year = "2018",
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Chang, PY, Huang, CC, Hung, CH, Yu, CY, Wu, DK, Hwang, JI, Liang, PC, Wu, RH, Tsai, WL, Lin, YJ, Liu, YS, Liang, HL, Lee, RC & Chen, CH 2018, 'Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment', Liver Cancer, vol. 7, no. 4, pp. 312-322. https://doi.org/10.1159/000487608

Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment. / Chang, Pi Yi; Huang, Chun Chieh; Hung, Chao Hung; Yu, Chih Yung; Wu, Ding Kwo; Hwang, Jen I.; Liang, Po Chin; Wu, Reng Hong; Tsai, Wei Lun; Lin, Yih Jyh; Liu, Yi Sheng; Liang, Huei Lung; Lee, Rheun Chuan; Chen, Chien Hung.

In: Liver Cancer, Vol. 7, No. 4, 01.10.2018, p. 312-322.

Research output: Contribution to journalArticle

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T1 - Multidisciplinary Taiwan consensus recommendations for the use of DEBDOX-TACE in hepatocellular carcinoma treatment

AU - Chang, Pi Yi

AU - Huang, Chun Chieh

AU - Hung, Chao Hung

AU - Yu, Chih Yung

AU - Wu, Ding Kwo

AU - Hwang, Jen I.

AU - Liang, Po Chin

AU - Wu, Reng Hong

AU - Tsai, Wei Lun

AU - Lin, Yih Jyh

AU - Liu, Yi Sheng

AU - Liang, Huei Lung

AU - Lee, Rheun Chuan

AU - Chen, Chien Hung

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials. Since Lencioni et al. [Cardiovasc Intervent Radiol 2012; 35: 980-985] published the first widely accepted technical recommendations on HCC embolization with DEBDOX-TACE in 2012, new studies have contributed to a better understanding of when and how to apply this new therapeutic modality, and they have yet to be incorporated into an updated guideline. Additionally, differences in the underlying liver pathology and practice of transcatheter embolization between Asian and Western populations have not been adequately addressed, and there remain significant variations in the TACE protocols adopted in different parts of the world. These mainly revolve around the number and type of chemotherapeutic agents used, type of embolic material, reliance on Lipiodol, and selectivity of catheter positioning. As a result of these issues, it has been difficult to interpret and compare results obtained from different centers in a systematic fashion. To address these concerns, we convened a panel of experts specializing in different aspects of HCC treatment to craft an updated set of recommendations that better reflect recent clinical experiences and are tailored to the use of DEBDOX-TACE in Taiwan. The conclusions of this expert panel are described in the following article.

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