Background and Objectives: Chemoembolization with doxorubicin drug eluting beads (DEB) is a novel locoregional treatment modality for unresectable hepatocellular carcinoma (HCC). Initial animal studies and clinical trials suggest that treatment with DEB may provide safer and more effective short-term outcomes than conventional chemoembolization. Current study explores long-term survival benefits. Methods: Consecutive patients who received transcatheter therapy with DEB or conventional chemoembolization as sole therapy between 1998 and 2008 were studied. Statistical analysis was performed using Kaplan-Meier estimator with log-rank testing, chi-squared, and independent t-tests. Results: Seventy-one patients were included in this study, 45 (63.4%) received therapy with DEB (group A) and 26 (36.6%) underwent conventional chemoembolization (group B). Median survival from diagnosis of HCC in groups A and B were 610 (351-868) and 284 days (4-563; P ¼ 0.03), respectively. In Okuda stage I, survival in groups A and B were 501 (421-528) and 354 days (148-560, P ¼ 0.02). In Child-Pugh classes A and B, survival in groups A and B were 641 (471-810) and 323 days (161-485, P ¼ 0.002). Median survival in patients with Cancer of Liver Italian Program (CLIP) score 3 in groups A and B were 469 (358-581) and 373 days (195-551, P ¼ 0.03). NCI CTCAEv3 Grade 5 clinical toxicity was similar. Conclusions: In our study, transcatheter therapy with DEB offers a survival advantage over conventional chemoembolization for patients with unresectable HCC.

Child-Pugh class, Okuda staging, bilirubin > 2 mg/dl, albumin < 3 g/dl, MELD score, serum AFP, CLIP score, Milan criteria, ECOG PS and BCLC staging were found to be prognostic markers of survival after treatment with doxorubicin DEB TACE in patients with unresectable HCC.

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Purpose: To investigate survival benefits and tumor treatment response among patients who received treatment with transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone. Materials and Methods: A total of 108 HCC patients were treated with TACE between the period of 1998 and 2008. 51 (47.2%) received TACE followed by planned RFA and 57 (52.8%) received TACE alone. 57 patients received Precision TACE with Doxorubicin drug eluting beads and 51 received conventional TACE. Survival analysis was performed using Kaplan Meier Estimator with a log rank test, Fischer exact test was performed for categorical variables and the t test for continuous variables. Results: Mean MELD (Model for End Stage Liver Disease) score among the TACE-RFA and TACE-only groups were 12.87 and 12.33 respectively (p = 0.64). The number of patients in Child’s Class A, B, C in the two groups were 28/15/8 and 23/23/11 (p = 0.30); in Okuda Class I, II and III in the two groups were 22/23/6 and 14/30/9 (p = 0.2). Median survival among patients who received TACE-RFA and TACE alone were 566 days and 209 days (p = 0.01). Median survival of patients treated with Precision-TACE + RFA was 566 days and that of patients treated with conventional TACE + RFA was 336 days (p = 0.510). Mean progression-free duration by RECIST criteria among the TACE + RFA group was 210 days vs. TACE only group 97 days (p = 0.04). Conclusion: Combination therapies of TACE and RFA were associated with improved overall survival than TACE alone. Patients with single tumors <5 cm appeared to have a su...

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