Low-Dose and Short-Course Dexamethasone Treatment as a New Therapy against the Post-Embolization Syndrome after Transcatheter Arterial Chemoembolization in Primary Liver Cancer: A Retrospective Case-Control Study

Abstract

Objective: Dexamethasone (DEX) is considered an effective treatment for Post-Embolization Syndrome (PES). However, the current commonly used DEX treatment course is long and involves a large amount of DEX and thus causes substantial side effects. This study aimed to evaluate the efficacy and safety of low-dose shortcourse DEX treatment in the prevention of PES to establish a new treatment course. Methods: A retrospective cohort study was conducted to observe the efficacy of DEX in treating PES on patients with primary liver cancer who underwent Transcatheter Arterial Chemoembolization (TACE). DEX was selected according to the wishes of the patients, who were subsequently divided into two groups. In the experimental group, 52 patients daily received an intravenous injection of 5 mg DEX and 5 mg tropisetron, starting on the day of TACE. The remaining 52 patients (control group) were treated with only 5 mg tropisetron daily. Incidence and degree of vomiting, abdominal pain, and fever were recorded. Routine blood tests and the C-Reactive Protein (CRP) test were performed, liver and kidney functions were evaluated, and the coagulation index and Eastern Cooperative Oncology Group (ECOG) performance status were assessed before and after TACE. Results: Severity scores of adverse reactions, such as vomiting, fever, and abdominal pain; incidence of grade 2 and 3 adverse reactions; and CRP and ECOG scores were significantly lower in the experimental group than in the control group (P< 0.05). There was no significant difference in routine blood parameters, liver and kidney functions, or coagulation between the two groups before or after TACE (P> 0.05). Conclusion: Low-dose and short-course DEX treatment after TACE can effectively reduce the severity of PES without side effects.