Comparison of doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE) with conventional transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma

• Published in: Radiología (English ed.) Vol. 53; no. 3; pp. 246 - 253
• Main Authors: Ferrer Puchol, M.D, la Parra, C, Esteban, E, Vaño, M, Forment, M, Vera, A, Cosín, O
• Format: Journal Article
• Language: English
• Published: Elsevier España 2011
• Subjects: Carcinoma; Doxorubicin-eluting beads; Hepatocarcinoma; Hepatocellular carcinoma; Hígado; Intra-arterial chemoembolization; Liver; Microesferas de adriamicina; Quimioembolización intraarterial; Radiology; Terapéutica; Treatment; Hígado; Treatment; Carcinoma; Doxorubicin-eluting beads; Intra-arterial chemoembolization; Liver; Terapéutica; Quimioembolización intraarterial; Hepatocellular carcinoma; Microesferas de adriamicina; Hepatocarcinoma
• ISSN: 2173-5107; 2173-5107
• DOI: 10.1016/S2173-5107(11)70014-3

Abstract Objective To compare conventional transarterial chemoembolization (TACE) with doxorubicineluting bead transarterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma, evaluating the tumor response, complications after treatment, and survival. Material and methods We present 72 patients diagnosed with hepatocellular carcinoma treated consecutively between January 2000 and December 2009. We studied 25 patients treated with TACE (Group A) and 47 patients treated with DEB-TACE (Group B); adriamycin (doxorubicin) was the chemotherapy agent used in both groups. All patients had compensated cirrhosis of the liver classified on the Child-Pugh score. The results were analyzed according to the RECIST criteria. Statistical analyses consisted of ANOVA, chi-square tests, Student's t-tests, and Kaplan-Meier log-rank tests. Results Patient's age, tumor size, number of tumors, and hepatic reserve were similar in the two groups. The mean number of sessions per patient was 1.32 ± 0.67 in Group A versus 2.13 ± 0.95 in Group B. The mean dose of adriamycin per patient was 50.60 ± 29.95 mg in Group A and 231.91 ± 110.2 mg in Group B. A complete response of the tumor to treatment was observed in 5.6 % of the patients in Group A and in 13.9 % of those in Group B. According to the RECIST criteria, no significant differences were found. DEB-TACE was better tolerated and had fewer immediate complications (p = 0.001). No significant differences were found in the survival of patients in the two groups (Group A: mean 686.24 days, median 709 days; Group B: mean 765.32 days, median 672 days. Conclusion In patients with unresectable hepatocellular carcinoma, DEB-TACE is safe and better tolerated than conventional TACE; moreover, it seems to lead to greater necrosis of the tumors.