Abstract :
Background: Fever is common sequelae after transcatheter arterial chemoembolization (TACE). Although
there are studies showing that the a tumor necrosis is the main cause of post-TACE fever, the actual causes
of fever is an individual patient often raises concerns by the attending physician, leading to extensive septic workup
and initiation of antibiotic treatment. The aim of this study was to assess the causes of and the factors predicting
fever after TACE.
Methods: Twenty-one patients with inoperable HCC underwent 40 sessions of TACE treatment. Data
was collected and analyzed on demographic patterns, potential predictive factors for post TACE fever, correlations
between post-TACE fever and chemoembolization dosage or tumor size, and incidence of post-procedural infection.
Results: Post-TACE fever occurred in 85% of the study population, with the mean duration of 3 ± 2.4
day. The mean tumor size was 6.1 ± 4.2 cm, the mean chemoembolization dosage 46 ± 13 mg/mL, and 42%
considered as effective treatment by revised RECIST criteria. Usage of gelfoam embolization (OR16, 95%CI 1.87-
136.70, p = 0.011), a larger tumor size (8.0 ± 4.7 vs. 4.4 ± 1.4 cm, p = 0.001) and a higher total dose delivery of
chemoembolizing agents (47 vs. 38 mg/mL, p = 0.002) were the predictive factors of post-TACE fever. Tumor
volume, chemoembolizing dosage, and elevation of serum AST, ALT after TACE appeared to correlate with the
duration of fever (p < 0.007, 0.056, 0.022, 0.034 respectively) but not so strongly (r = 0.457, 0.331, 0.456, 0.417
respectively). No evidence of infection was found in any study patient, and no useful of pre-TACE biochemistry
test can predict the occurrence of post-TACE fever in this study.
Conclusion: Fever after TACE was common. The predictive factors of post-TACE fever were the
usage of gel foam embolization, |
file/Thai-Journal-of-gastroenterology-vol-13-no-2-71410.pdf