All patients with HCC were treated using conventional TACE by two experienced interventional radiologists who had at least 10 years of experience. We administered a mixture of iodized oil (range: 4–16 mL) and doxorubicin hydrochloride (range: 5–50 mg) or mitomycin-C (range: 10–20 mg) via the tumor-feeding hepatic arteries. We finished the procedure when the tumor feeding branch was completely embolized by gelatin sponge particles. The decision to repeat TACE session was made on demand at an interval of 6–12 weeks in patients with favorable liver function and performance status.
We evaluated baseline CT scans before TACE and 1-month post-TACE to evaluate TACE responses. The treatment response was assessed based on the imaging studies of the patients, which were either 4-phase contrast-enhanced CT scan or dynamic magnetic resonance imaging within 1 month after the initial TACE. The modified Response Evaluation Criteria in Solid Tumors (mRECIST) was used to assess radiological changes of HCC after treatment16 (link). The criteria have four categories; complete response (CR); partial response (PR); stable disease (SD); and progressive disease (PD). Complete or partial response in the imaging study at 1-month post-TACE was classified as TACE response whereas stable or progressive disease was defined as no response. Assessment of tumor response was reviewed independently by two radiologists with expertise in liver imaging to minimize variability. In cases of disagreement, the final decision was obtained by consensus.
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