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Conventional versus drug‐eluting beads chemoembolization for hepatocellular carcinoma: Emphasis on the impact of tumor size
Author(s) -
Lee Yong Kang,
Jung Kyu Sik,
Kim Do Young,
Choi Jin Young,
Kim Beom Kyung,
Kim Seung Up,
Park Jun Yong,
Ahn Sang Hoon,
Han KwangHyub,
Kim Gyoung Min,
Kim Man Deuk,
Park Sung Il,
Won Jong Yun,
Lee Do Yun
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13501
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , clinical endpoint , complication , single center , response evaluation criteria in solid tumors , surgery , liver disease , transcatheter arterial chemoembolization , liver cancer , progressive disease , chemotherapy , clinical trial
Background and Aim This study aims to evaluate clinical outcomes of patients with hepatocellular carcinoma who underwent transarterial chemoembolization (TACE) using drug‐eluting beads (DEB). Patients and Methods This study retrospectively compared the clinical outcomes of 250 consecutive patients who underwent DEB‐TACE ( n = 106) or conventional TACE (cTACE) ( n = 144) in a tertiary center between January 2010 and April 2014. The median age of the patients was 62 years and 81.6% were men. The primary endpoint was overall survival (OS). The time to progression (TTP), radiological response rate using modified response evaluation criteria in solid tumors criteria at 1 month after treatment, and complication rates within 1 month were also compared. Results The most common etiology was hepatitis B virus infection. The median index tumor size was 2.8 cm, and 150 (60.0%) patients had Barcelona Clinic Liver Cancer stage B. Median TTP in the cTACE group was longer than in the DEB‐TACE group (13.3 vs 10.8 months; P = 0.023). However, DEB‐TACE and cTACE groups showed no significant differences for mean OS (46.6 vs 44.9 months; P = 0.660) and disease control rate at 1 month (78.3% vs 86.8%; P = 0.076). The OS, TTP, and disease control rate were also not different between two groups, even when subgrouped by index tumor size. The complication rates within 1 month were higher in the cTACE group (6.6% vs 14.6%; P = 0.048). Conclusions Drug‐eluting beads TACE appears to be a safe intra‐arterial therapy. However, it is not superior to cTACE in terms of efficacy. Tumor size might not be a criterion to select treatment modality between cTACE and DEB‐TACE in terms of efficacy.