Transarterial chemoembolization and bland embolization for hepatocellular carcinoma

Abstract

Transarterial chemoembolization (TACE) is the first line treatment for patients with intermediate stage hepatocellular carcinoma but is also increasingly being used for patients on the transplant waiting list to prevent further tumor growth. Despite its widespread use, TACE remains an unstandardized procedure, with variation in type and size of embolizing particles, type and dose of chemotherapy and interval between therapies. Existing evidence from randomized controlled trials suggest that bland transarterial embolization (TAE) has the same efficacy with TACE. In the current article, we review the use of TACE and TAE for hepatocellular carcinoma and we focus on the evidence for their use.

Systematic review comparing the safety and efficacy of conventional and drug‐eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma

“…Similar OS for both DEB‐TACE and cTACE may mean that embolization, rather than the antitumor drug, provides most of the therapeutic effect. This is certainly consistent with the conclusions of several systematic reviews and research from our own group showing similar OS for TACE and transarterial embolization. On the other hand, the present meta‐analysis shows that DEB‐TACE leads to a significantly higher objective tumor response than cTACE, as reported in a previous meta‐analysis .…”

Transcatheter arterial embolisation in four dogs with hepatocellular carcinoma

“…In the veterinary field, adverse effects and treatment response to TACE remain unclear. Although there is still controversy regarding the efficacy of TAE versus TACE (Forner et al 2007), previous research in humans demonstrates that TAE may be as effective as TACE while being less expensive and devoid of adverse effects due to the lack of chemotherapy (Tsochatzis et al 2014).…”

Engineered polymeric microspheres obtained by multi-step method as potential systems for transarterial embolization and intraoperative imaging of HCC: Preliminary evaluation

“…The embolic agents are injected to the target site with a minimally invasive procedure, through a catheter facilitating artery occlusion. This strategy provides localized therapy directly to hepatic tumours, leading to cancer destruction and protecting the rest of the liver against necrosis [11,12]. Over the years, a variety of embolic agents has been employed as liquids, coils, and particulate systems, classified as spherical or non-spherical [13].…”