Drug-eluting bead transarterial chemoembolization (TACE) vs conventional TACE in treating hepatocellular carcinoma patients with multiple conventional TACE treatments history

Abstract

This study aimed to compare the efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) vs conventional TACE (cTACE) in hepatocellular carcinoma (HCC) patients with multiple cTACE treatments history. Eighty-one HCC patients with multiple cTACE treatments history who underwent DEB-TACE (N = 42) and cTACE treatment (N = 39) were included in this retrospective cohort study and allocated to DEB-TACE and cTACE groups accordingly. Multiple cTACE treatments history was defined as history of three or more cycles cTACE treatments. Then treatment responses were assessed according to the criteria of modified Response Evaluation Criteria in Solid Tumors (mRECIST), and progression free survival (PFS), as well as overall survival (OS), was calculated. In addition, adverse events and liver function related indexes were recorded. Complete response ( P = .167) was of no difference while objective response rate (ORR) ( P = .003) was increased in DEB-TACE group compared with cTACE group. Patients in DEB-TACE group presented with more favorable PFS ( P = .028) and OS ( P = .037) compared with cTACE group. Further analysis revealed that DEB-TACE (vs cTACE) was an independent predictive factor for better ORR ( P = .001), PFS ( P = .006) and OS ( P = .001). The albumin (ALB) level at first month after treatment was elevated ( P = .015) while the other liver function indexes levels did not vary (all P > .05) in DEB-TACE group compared with cTACE group. The incidences of pain ( P = .327), fever ( P = .171) and nausea/vomiting ( P = .400) during hospitalization were similar between the 2 groups. DEB-TACE is more efficient and equally tolerant compared with cTACE in HCC patients with multiple cTACE treatments history.

Hepatocellular Carcinoma With Different Areas of Right Retroperitoneal Space Invasion: Evaluation of Transcatheter Arterial Chemoembolization Efficacy and Blood Supply Characteristics

“…At the main endpoint of this study, we found that the median OS of the group with SARPS invasion was significantly longer than that of the group with RAPS invasion. In terms of secondary endpoints, overall, the ORR and DCR were only 48.9% and 63.4%, respectively, similar to the results described by Li et al (29), which may be related to the large tumors (n = 35, >5 cm), PV/HV branch invasion, and retroperitoneal invasion in the patients we included. However, the ORR and DCR were significantly higher in the group with SARPS invasion than in the group with RAPS invasion, which we believe that this finding may be related to the location and aggressiveness of the tumors, since there were no notable differences in baseline characteristics among patients with HCC with different areas of rRPS invasion, we believe that these data were justified.…”

<p>Drug-eluting Bead-Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma Refractory to Conventional Lipiodol-based Transcatheter Arterial Chemoembolization</p>

“… 30 Furthermore, a recent study with HCC patients (including patients with Child–Pugh A, 85.7% and Child–Pugh B, 14.3%) showed that DEB-TACE was effective in HCC patients with multiple c-TACE treatments history compared with continuous c-TACE treatments. 31 In this study, a large nodule (more than 7 cm) and advanced BCLC stage (C/D) were independent poor prognostic factors. 31 In the present study, although antitumor effect was independent of UT7 criteria, tumor size was relatively small (median 2.5 cm).…”

“…Furthermore, we evaluated HCC status of the liver with "up-to-seven (UT7) criteria" 24 because intrahepatic tumor factors such as size and number of tumor are known to be associated with effectiveness of TACE and patients' survival after TACE. 25,26 Written informed consent was obtained from all participants before treatment, and this study was approved by our institutional ethics committee (Ethics Committee, University of Toyama, Approved Number: [25][26][27][28][29][30][31]. This study was conducted in accordance with the Declaration of Helsinki.…”

A novel application of drug-eluting transarterial chemoembolization in treating non-liver cancers

“…This might also affect the treatment efficacy, as there are already studies elucidating a better efficacy of DEB compared with TACE using lipiodol and conventional embolic agents. [ 25 – 27 ] However, these studies are all conducted in liver cancer patients but not other malignancies, therefore, the effect of embolic agents (both DEB and conventional embolic agents) on efficiency and safety in patients with cancers other than liver cancer should be evaluated in future studies with larger sample size. Moreover, complementary embolization is used in some of our patients (most of who have large tumors), which is also a factor influencing the efficacy that should be investigated in future studies.…”