Authors (including presenting author) :
KWOK, TW (1); WONG, SM (2); YU, CH (2); YOUNG, WM (1)
Affiliation :
(1) Department of Pharmacy, Tuen Mun Hospital (2) Department of Radiology & Nuclear Medicine, Tuen Mun Hospital
Introduction :
In patients with unresectable hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) is the mainstay of treatment with established benefits of prolonging survival and improving quality of life. A few major suspected HSRs related to TACE with cisplatin were observed in the institution within a short period of time. It led us to wonder whether the incidence of HSRs would be similar in intravenous use and intra-arterial use of cisplatin, and whether similar situation of HSRs would have been documented in other populations. However, data on hypersensitivity reactions (HSRs) to the intra-arterial use of cisplatin are still limited.
Objectives :
To retrospectively review the incidence of HSRs and the risk factors in patients with unresectable HCC who have undergone TACE with cisplatin-lipiodol suspension.
Methodology :
Between September 2014 and December 2019, 882 TACE documentations involving 257 HCC patients treated with cisplatin-lipiodol suspension were retrieved from the Pharmacy Oncology Drugs Preparation System. This retrospective cohort study reviewed the incidence of HSRs and the risk factors by binary logistic regression analysis. Statistical significance was set at a p-value of < 0.05. All analyses were conducted using the SPSS software (version 16; SPSS, Chicago, Illinois).
Result & Outcome :
A total of 882 TACE procedures were involved in 257 HCC patients. The median number of TACE procedures performed per patient was 3 (range: 1 – 23). The median dose of cisplatin per TACE session was 4.2 mg (range: 0.42 mg – 21 mg), while the median accumulated dose of cisplatin per patient was 15.42 mg (range: 0.52 mg – 125 mg). HSRs were identified in 28 out of 882 procedures (3.17%) [20 out of 257 patients (7.78%)]. The median number of TACE procedures performed in these patients was 2.5 (range: 1 – 17). The median dose of cisplatin per TACE session was 5.83 mg (range: 0.63 mg – 20 mg), while the median accumulated dose of cisplatin per patient was 17.09 mg (range: 3.33 mg – 47.99 mg). On binary logistic regression analysis, parameters that showed statistically significant and independent association with HSRs include performance of 9 or more TACE procedures (p = 0.035) and dose of cisplatin of 8.54 mg or more per session (p = 0.031).
