Comparison of Clinical Efficacy and Safety between 70–150 µm and 100–300 µm Doxorubicin Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

Abstract

Background: This study aimed to compare the efficacy and safety of 70–150 μm doxorubicin drug-eluting bead (DEB) transarterial chemoembolization (TACE) with those of 100–300 μm DEB-TACE as first-line treatment in patients with hepatocellular carcinoma (HCC). Methods: We retrospectively investigated 72 patients who underwent TACE with 70–150 μm DEBs (n = 40) or 100–300 μm DEBs (n = 32) for HCC in a tertiary center between March 2013 and May 2019. Initial treatment response and adverse events were assessed using the modified Response Evaluation Criteria in Solid Tumors and the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0, respectively. Results: At the 2-month post-treatment assessment, the complete and objective response rates were 47.5% and 85.0%, respectively, for the 70–150 μm group and 34.4% and 81.3%, respectively, for the 100–300 μm group; however, the difference was not statistically significant (p > 0.05). In total, 65% patients in the 70–150 μm group and 59.4 % patients in the 100-300 μm group experienced at least one symptom of post-embolization syndrome after TACE; all symptoms were classified as grade 1 or 2. There was no significant difference between the two groups in terms of post-procedural laboratory changes such as changes in liver enzymes and bilirubin levels (p > 0.05). Laboratory toxicity of grade 3 occurred in three patients, all of which were transient elevation of liver enzyme levels. Hepatobiliary adverse events, such as bile duct injury, biloma, liver abscess, and hepatic infarction, were not observed in either treatment group. Conclusion: This study found no significant difference in tumor response between 70–150 μm and 100–300 μm DEB-TACE. Both groups showed favorable safety profiles, and the difference was not significant.

Conventional vs. Drug-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma—A Propensity Score Weighted Comparison of Efficacy and Safety

“…Several studies reported good outcome in terms of tumor response, PFS, and OS for DEBs <100 μm [ 37 , 38 , 39 ] and >100 μm [ 19 ] in individual single-arm prospective and retrospective studies in HCC patients. While a recent retrospective comparison of DEB-TACE with 70–150 μm DEBs or 100–300 μm DEBs in HCC patients reported no significant differences in tumor response or AEs [ 40 ], prior comparative studies demonstrated favorable efficacy in terms of tumor response and similar or improved OS and PFS after smaller-caliber DEB-TACE compared to medium- or large-size DEBs in HCC patients [ 41 , 42 ].…”

Evaluation of Pretreatment Albumin–Bilirubin Grade as a Better Prognostic Factor Compared to Child–Pugh Classification in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization Combined with Radiotherapy

“…The detailed procedure for TACE at our institution has been described previously [ 18 , 19 ]. RT was performed for either curative or palliative aims according to the guidelines of the Korean Liver Cancer Association [ 20 , 21 ] and applied after the general condition recovery of patients with a stabilized liver enzyme found in blood chemistry evaluation.…”

Polymeric Microspheres Designed to Carry Crystalline Drugs at Their Surface or Inside Cavities and Dimples

“…DEE microparticles increase drug concentrations in tumors and reduce systemic drug exposure compared to conventional drug delivery methods. This strategy has proven particularly suitable for transarterial chemoembolization of hepatic malignancies [ 13 , 14 , 15 , 16 ]. Currently, there are seven commercial products for TACE with DEE microparticles [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”