Resumen

Background: Transarterial chemoembolisation (TACE), having demonstrated survival benefits, is the treatment of choice in intermediate-stage hepatocellular carcinoma, although there is great heterogeneity in its clinical application. Material and methods: A survey was sent to the Madrid Regional hospitals to assess applicability, indications and treatment protocols. The assessment was made overall and according to the type of hospital (groups A vs. B and C). Results: Seventeen out of 22 hospitals responded (8/8 group A, 9/14 group B-C). All do/indicate transarterial chemoembolisation, 13/17 at their own facilities. Eight of the 17 hospitals have multidisciplinary groups (5/8 A, 3/9 B-C). Nine hospitals perform > 20 procedures/year (7 group A), and 6 from group B-C request/perform < 10/year. It is performed on an “on-demand” basis in 12/17. In 5 hospitals, all the procedures use drug-eluting beads loaded with doxorubicin. The average number of procedures per patient is 2. The mean time from diagnosis of hepatocellular carcinoma to transarterial chemoembolisation is ≤ 2 months in 16 hospitals. In 11/17 hospitals, response is assessed by computed tomography. Radiological response is measured without specific criteria in 12/17 and the other five hospitals (4 group A) assessed using standardised criteria. Conclusion: Uniformity among the Madrid Regional hospitals was found in the indication and treatment regimen. The use of DEB-TACE has become the preferred form of TACE in clinical practice. The differentiating factors for the more specialised hospitals are a larger volume of procedures, decision-making by multidisciplinary committees and assessment of radiological response more likely to be standardised.

Palabras clave: Lipiodol drug-eluting beads Barcelona Clinic Liver Cancer System.

2015-02-04   |   374 visitas   |   Evalua este artículo 0 valoraciones

Vol. 14 Núm.2. Marzo-Abril 2015 Pags. 207-217 Ann Hepatol 2015; 14(2)