Journal of Liver Cancer

Original Article

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages: Kwang-Hun Lee, Seung-Moon Joo, Tae Jun Yum, Sang Hoon Jung; J Liver Cancer. 2017;17(2):144-152. Published online September 30, 2017; DOI: https://doi.org/10.17998/jlc.17.2.144

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Background/Aims
To retrospectively compare conventional and drug-eluting beads transarterial chemoembolization (C-TACE and DEB-TACE) for treatment of hepatocellular carcinoma (HCC) at very early and early stages.
Methods
We retrospectively compared patients treated with C-TACE (n=115) or DEB-TACE (n=103) from September 2009 to May 2016. All patients were in a very early (stage 0) or early stage (stage A) of the Barcelona Clinic Liver Cancer (BCLC) staging system, and all had Child– Pugh class A and ≤B7 liver status. Approval by the institutional review board was waived because the study was retrospective. The following parameters were evaluated: severe pain and bradycardia during TACE, post-embolization syndrome (PES), liver function change, complications, target tumor response, and conversion to another treatment modality. Numeric differences were assessed by the independent Student’s t-test for continuous variables and by chi-square test for categorical variables.
Results
Severe intractable pain and bradycardia during the TACE procedure were significantly more frequent in the C-TACE group than in the DEB-TACE group (P<0.001). The incidence and duration of PES were significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The increase in liver enzymes was significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The deterioration of the Child-Pugh class was significantly higher in the C-TACE group than in the DEB-TACE group (P =0.006). There was no significant difference in serious complications except localized bile duct dilatation between the groups. There was no significant difference between the groups in tumor response at both immediate and 1-year assessment. The conversion rate to other treatment modalities was significantly higher in the DEB-TACE group than in the C-TACE group (P<0.001).
Conclusions
DEB-TACE is better than C-TACE in terms of procedural safety as initial treatment in a very early or early stage of HCC.

Citations

Citations to this article as recorded by

Superselective ablative chemo-ethanol embolization for recurrent single hepatocellular carcinoma: a 6-month outcome analysis
Jae Hwan Lee, Kun Yung Kim, Chong-ho Lee, Minuk Kim, Chang Jin Yoon
Journal of Liver Cancer.2024; 24(2): 217. CrossRef
Drug-Eluting Bead Transarterial Chemoembolization Versus Radiofrequency Ablation as an Initial Treatment of Single Small (≤ 3 cm) Hepatocellular Carcinoma
Somin Lee, Yong Yeon Jeong, Byung Chan Lee, Sang Soo Shin, Suk Hee Heo, Hyoung Ook Kim, Chan Park, Won Gi Jeong
Journal of Korean Medical Science.2023;[Epub] CrossRef
Current status of transarterial chemoembolization (TACE) agents in hepatocellular carcinoma treatment
Roshana Saghafian Larijani, Nazanin Shabani Ravari, Navid Goodarzi, Shahram Akhlaghpour, Samaneh Saghafian Larijani, Mohammad Reza Rouini, Rassoul Dinarvand
Journal of Drug Delivery Science and Technology.2022; 77: 103905. CrossRef
Transarterial chemoembolization using drug-eluting bead compared with radiofrequency ablation for treatment of single small hepatocellular carcinoma: a pilot non-randomized trial
Tae Hoon Kim, Na Hye Kim, Jin Dong Kim, Young Nam Kim, Yu Jin Kim, Eun Jung Kim, Ki Deok Yoo, Choong Heon Ryu, Ha Hun Song, Hyun Kim
Journal of Liver Cancer.2021; 21(2): 146. CrossRef

Review Article

Transarterial Chemoembolization with Drug-Eluting Beads for Hepatocellular Carcinoma: Myeong Jun Song; Journal of the Korean Liver Cancer Study Group. 2012;12(2):88-92. Published online September 30, 2012

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Abstract PDF: Transarterial chemoembolization (TACE) has been widely used as a standard treatment for HCC patients who are not suitable candidates for curative treatments and as a bridge to liver transplantation. The rationale for TACE is that the intra-arterial chemotherapy using lipiodol and chemotherapeutic agents, followed by selective vascular embolization, will result in a strong cytotoxic effect combined with ischemia (conventional TACE). Recently, drug-eluting beads (DC Bead®) for the transcatheter treatment of HCC have been developed to deliver higher doses of chemotherapeutic agent and to prolong contact time with the tumor. DC Bead® has the ability to actively sequester doxorubicin hydrochloride from solution and release it in a controlled and sustained fashion. Treatment with DC Bead® has been shown to substantially diminish the amount of chemotherapeutic agent that reaches the systemic circulation compared with conventional, lipiodol-based regimens, significantly reducing drug-related adverse events. In this article, we describe the treatment efficacy and safety of TACE with the drug-eluting bead for the treatment of hepatocellular carcinoma and discuss future therapeutic possibilities.

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