Chemo-embolization in the treatment of hepatocellular carcinoma: should we switch to charged particles in our countries? About 102 procedures of a North African radiology center.

2018 
BACKGROUND: Hepatocellular carcinoma (HCC) is a public health problem in african countries. The chemoembolization (CE) could represent the only therapeutic strategy. Two methods can be proposed: charged microparticles and lipiodol chemoembolization. The purpose of this study was to compare results, morbidity and survival between charged microparticles and lipiodol chemoembolization. METHODS: A 5 years retrospective, study was conducted including 62 patients with HCC treated by chemioembolization. The efficacy of the treatment was evaluated for patients by performing a computed tomography four to six weeks after the act. We used « European Association for Study of the Liver » criteria to evaluate the therapeutic outcome. RESULTS: A total of 102 sessions of chemoembolization were performed. This was a with charged microparticles in 70 cases (68.6%) and lipiodol chemoembolization in 32 cases (31.3 %). The difference was not significant between the two CE techniques (lipiodol and charged microparticles) in terms of complete and objective response and complications. The mean survival rate was 30 months ± 4 for all techniques combined, with no statistically significant difference in terms of survival time without recurrence between the two chemoembolization techniques. CONCLUSION: The efficacy, morbidity and survival of the two CE techniques to lipiodol or microfilled particles are comparable. The selectivity of the technique is to be taken into consideration. For economic health purposes, the CE lipiodolee appears to be more adapted to the context of the developing African countries.
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