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  • Safety evaluation of combin...
    Chiu, Sung-Hua; Lin, Hsuan-Hwai; Feng, An-Chieh; Lo, Cheng-Hsiang; Hsieh, Chung-Bao; Chen, Pin-Ko; Chang, Wei-Chou

    European journal of radiology, January 2024, 2024-Jan, 2024-01-00, 20240101, Letnik: 170
    Journal Article

    •The risk of liver abscess after DEB-TACE increased as treatment interval of DEB-TACE and ICIs was less than one month.•Though with higher incidence, liver abscess after DEB-TACE as in combination with ICIs didn’t show more aggressive course.•Receiving ICIs before DEB-TACE exhibited a trend toward liver abscess formation compared with receiving DEB-TACE before ICIs. To analyze the safety of combination treatment comprising drug-eluting bead transarterial chemoembolization (DEB-TACE) and immune checkpoint inhibitors (ICIs) in hepatocellular carcinoma (HCC). In total, 208 HCC patients receiving DEB-TACE were enrolled for this retrospective single-institution study. Among them, 50 patients who received ICIs at an interval less than one month from DEB-TACE were categorized into the DEB-ICI group; the remaining 158 patients were categorized into the DEB group. Albumin-bilirubin (ALBI) score before and at three months after DEB-TACE were recorded to evaluate liver function changes. Adverse events within three months after DEB-TACE were considered TACE-related and were compared between the two groups. The DEB-ICI group had significantly higher incidence of liver abscess than the DEB group (14.0 % versus 5.1 %, p-value = 0.0337). No significant difference in the other TACE-related adverse events and change of ALBI score between the groups. Univariate logistic regression confirmed that combination with ICIs was an independent risk factor for liver abscess after DEB-TACE (odds ratio = 3.0523, 95 % confidence interval: 1.0474–8.8947, p-value = 0.0409); other parameters including subjective angiographic chemoembolization endpoint scale and combined targeted therapy were nonsignificant risk factors in this study population. In the DEB-ICI group, patients who received ICIs before DEB-TACE exhibited a trend toward liver abscess formation compared with those who received DEB-TACE before ICIs (23.8 % versus 6.9 %, p-value = 0.0922). Combination treatment involving DEB-TACE and ICIs at an interval less than one month increased the risk of liver abscess after DEB-TACE. Greater caution is therefore warranted for HCC patients who receive ICIs and DEB-TACE with this short interval.