A Retrospective Comparative Study of Four Different Transarterial Regimens for Treatment of Hepatocellular Carcinoma
Bibliographic record
Abstract
Background: Transarterial chemoembolization (TACE) is known to be a valid palliative measure in treating hepatocellular carcinoma (HCC). Indeed, it is considered as the first option in treating patients with unresectable multinodular HCC in the absence of portal vein thrombosis or invasion with preserved liver function. Furthermore, chemoembolization is also used as an adjuvant therapy to prevent tumor progression or to downstage the tumor to meet the transplantation criteria. Despite that, there is no standardized treatment regimen for chemoembolization. This single-center retrospective study aims to compare four different regimens of TACE for the treatment of unresectable HCC to assess tumor response, time to progression (TTP), and median survival. Methods: Ninety-eight TACE procedures on 88 patients with unresectable HCC (77 males and 11 females; mean age 68.4 years) performed between June 2007 and July 2014 were included. Four groups based on the regimen were compared. This includes 10 patients treated with I-131-lipiodol combined with cisplatin and doxorubicin (Group A), 15 patients treated with cisplatin and doxorubicin mixed with lipiodol (Group B), 53 patients treated with doxorubicin mixed with lipiodol (Group C), and 10 patients treated with doxorubicin-eluting beads (DEB-TACE) (Group D). The outcome measures reviewed were imaging response, TTP, technical success, and median survival. The tumor measurements were analyzed based on mRECIST criteria. Statistical analysis was performed using ANOVA and post hoc Tukey’s test. Results: There is no statistically significant difference in the baseline tumor size among the study groups ( P = 0.67): (Group A: mean 7.9 cm, median 6.3 cm; Group B: mean 6.1 cm, median 5.6 cm; Group C: mean 6.2 cm, median 5.7 cm; and Group D: mean 6.0 cm, median 4.7 cm). A complete response to the treatment was slightly higher in Groups B and C (15% and 13%, respectively) compared to Groups A and D (10%). The median TTP was shorter in Group A (4 months) compared to (6 months) Groups B, C, and D. There is no significant difference in median survival among the study groups ( P = 0.96). Conclusion: Based on our review, there is no significant difference in imaging response, TTP, and survival between single agent TACE, dual agent TACE, radio-chemoembolization with dual agents, and DEB-TACE. Publication History Article published online: 11 May 2021 © 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".