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

Abstract

This study compared the efficacy and safety of conventional transarterial chemoembolization (cTACE) with drug-eluting beads (DEB)-TACE in patients with unresectable hepatocellular carcinoma (HCC). This retrospective analysis included 370 patients with HCC treated with cTACE (n = 248) or DEB-TACE (n = 122) (January 2000–July 2014). Overall survival (OS) was assessed using uni- and multivariate Cox proportional hazards models and Kaplan-Meier analysis. Additionally, baseline imaging was assessed, and clinical and laboratory toxicities were recorded. Propensity score weighting via a generalized boosted model was applied to account for group heterogeneity. There was no significant difference in OS between cTACE (20 months) and DEB-TACE patients (24.3 months, ratio 1.271, 95% confidence interval 0.876–1.69; p = 0.392). However, in patients with infiltrative disease, cTACE achieved longer OS (25.1 months) compared to DEB-TACE (9.2 months, ratio 0.366, 0.191–0.702; p = 0.003), whereas DEB-TACE proved more effective in nodular disease (39.4 months) than cTACE (18 months, ratio 0.458, 0.308–0681; p = 0.007). Adverse events occurred with similar frequency, except for abdominal pain, which was observed more frequently after DEB-TACE (101/116; 87.1%) than cTACE (119/157; 75.8%; p = 0.02). In conclusion, these findings suggest that tumor morphology and distribution should be used as parameters to inform decisions on the selection of embolic materials for TACE for a more personalized treatment planning in patients with unresectable HCC.

Retrospective analysis of the efficacy and survival associated with cTACE and DEB-TACE in the palliative treatment of hepatocellular carcinoma: experience of a tertiary care hospital in southern Brazil

“…In the present study, survival did not differ significantly between the patients who underwent cTACE and those who underwent DEB-TACE. Similar results have been reported in some other studies and meta-analyses ( 15 , 19 - 22 ) . A large, multicenter randomized clinical trial conducted by Golfieri et al ( 15 ) (of the Precision Italia Study Group) showed that both techniques are equally effective and safe, with similar oneand two-year survival rates-86.2% and 56.8%, respectively, for DEB-TACE and 83.5% and 55.4%, respectively, for cTACE.…”

Liver Cancer: Improving Standard Diagnosis and Therapy

“…Savic et al compared the efficacy and safety of conventional and drug-eluting beads (DEB) trans-arterial chemoembolization (TACE) [ 8 ]. Although there were no significant differences in overall survival in conventional TACE and DEB-TACE, infiltrate or nodular features affected the overall survival.…”