Prospective Phase II trial of drug-eluting bead chemoembolization for liver transplant candidates with hepatocellular carcinoma and marginal hepatic reserve.

Purpose: To determine whether chemoembolization using drug-eluting beads (DEB-TACE) is safe and effective for liver transplantation candidates with liver-limited hepatocellular carcinoma (HCC) without vascular invasion and baseline hepatic dysfunction. Materials and methods: Seventeen adult liver transplantation candidates (median age 66 years, range 58-73 years; 13 men) with HCC were treated with DEB-TACE as a part of Stage 1 of a prospective single-institution Phase II trial. All patients had marginal hepatic reserve based on at least one of the following criteria: ascites (n=14), bilirubin between 3 and 6 mg/dL (n=5), AST 5-10 times upper normal limit (n=1), INR between 1.6 and 2.5 (n=4), portal vein thrombosis (n=2), and/or portosystemic shunt (n=2). Primary study objectives were safety and best observed radiographic response. Results: Thirty-seven DEB-TACE procedures were performed. Objective response rate and disease control rate were 63% and 88%, respectively. HCC progression was observed in 12 patients. Median time to progression was 5.6 months (range 0.9-13.6 months). Within 1 month following DEB-TACE, 13 patients (76%) developed grade 3 or 4 AE attributable to the procedure. Four patients (all within Milan Criteria) were transplanted (2.7-6.9 months after DEB-TACE), and 12 patients died (1.8-32 months after DEB-TACE). All deaths were due to liver failure that was either unrelated to HCC (n=5), in the setting of metastatic HCC (n=5), or in the setting of locally advanced HCC (n=2). Mortality rate at 1 month was 0%. Conclusions: DEB-TACE achieves tumor responses but carries a high risk of hepatotoxicity for liver transplant candidates with HCC and marginal hepatic reserve

Search for narrow N N pi resonances in exclusive p p ---> p p pi+ pi- measurements

Narrow structures in the range of a few MeV have been searched for in p p pi+ and p p pi- invariant mass spectra obtained from exclusive measurements of the p p -> p p pi+ pi- reaction at Tp = 725, 750 and 775 MeV using the PROMICE/WASA detector at CELSIUS. The selected reaction is particularily well suited for the search for NN and / or N Delta decoupled dibaryon resonances. Except for a possible fluctuation at 2087 MeV/c^2 in Mpppi- no narrow structures could be identified neither in Mpppi+ nor in Mpppi- on the 3 sigma level of statistical significance, giving an upper limit (95% C.L.) for dibaryon production in this reaction of sigma < 20 nb for 2020 MeV/c^2 < m(dibaryon) < 2085 MeV/c^