Initial Experience of Drug-Eluting Bead-Transcatheter Arterial Chemoembolization After Lipiodol-Based Transcatheter Arterial Chemoembolization Failure for Patients with Advanced Hepatocellular Carcinoma

Abstract

Purpose: To investigate the potential safety and efficacy of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) in treating TACE-refractory hepatocellular carcinoma (HCC). Methods: We retrospectively evaluated the treatment outcomes of DEB-TACE for 41 HCC nodules in 30 patients who were refractory to conventional TACE (c-TACE) according to tumor response. The antitumor response was evaluated according to mRECIST criteria, and changes in alpha-fetoprotein (AFP), albumin-bilirubin score, the incidence of adverse events, and the time to disease progression were observed. Results:The objective response rate and disease control rates were 60.98% and 95.12% at 4 weeks after DEB-TACE, 63.41% and 92.68% at 8 weeks, respectively. The median time of disease progression was 4.60 ± 0.23 months. The AFP of patients decreased continuously at 2-6 weeks after operation, and the AFP at 4 weeks was significantly lower than that at 2 weeks (P = 0.038). Adverse reactions were well tolerated, and no grade 4 adverse reactions were reported. The albumin-bilirubin score did not deteriorate within 6 weeks. Conclusion: DEB-TACE has potential efficacy and safety after failure of c-TACE in patients with advanced liver cancer. Further studies are needed to confirm the efficacy of DEB-TACE treatment after failure of c-TACE.

Prophylactic Use of Antibiotics for Postsurgical Infection in c-TACE and DEB-TACE High-Risk Patients: A Case-Control Study

“…The beads employed in DEB-TACE are mainly biocompatible polymers-based hydrogels including polyvinyl alcohol (PVA)-based hydrogels which are sulphonated for binding of anticancer drugs [ 9 ]. The anticancer agents are delivered to the target site upon occlusion of the beads in the vasculature, which embolizes them, and subsequently, the drug is released in the target site [ 10 ]. It is currently unclear whether DEB-TACE or c-TACE should be used for a specific patient in the absence of randomized-controlled trials.…”

A Simple Prognostic Scoring System for Hepatocellular Carcinoma Treated with DEB-TACE

“…Studies have shown that the ALBI classification has higher prognostic value than the Child-Pugh classification. 21–23 The presence of portal vein thrombosis increases the risk of metastasis and portal hypertension, leading to a higher likelihood of gastrointestinal bleeding, ascites, and liver failure. It is a significant factor affecting the prognosis of HCC patients.…”

Predicting Outcome in Combination Treatment of TACE and Camrelizumab for Advanced Hepatocellular carcinoma: Tumor Hypervascularity and Reactive Cutaneous Capillary Endothelial Proliferation

“…It blocks the blood supply of the tumor and accumulates high concentrations of chemotherapeutic drugs in the tumor to kill tumor cells to the greatest extent. 18 , 19 However, TACE can lead to ischemia and hypoxia of embolic tissue cells, stimulate the expression of VEGF in the residual lesions, thus promoting tumor angiogenesis and causing tumor recurrence and metastasis. At the same time, the long-term chronic inflammatory response of the tumor-bearing liver can upregulate PD-1 receptors and promote the spontaneous apoptosis of immune cells.…”