Trans-arterial chemoembolization (TACE) in treatment of non-resectable hepatocellular carcinoma: comparative study between conventional TACE and drug eluting bead TACE

To compare tumour response and complications of conventional TACE with lipidol versus DEB-TACE in the treatment of non-resectable HCC.Prospective non randomized comparative clinical trial was performed for patients receiving TACE at interventional radiology unit in Radiodiagnosis department in Zagazig university hospitals. Forty patients were included in this study, 16 patients were treated with drug eluting beads TACE and 24 patients were treated with conventional TACE.Follow up triphasic CT was performed 1 month after the procedure, we found that complete response was 6 cases (25 %) in c TACE group, and 4 cases (25%) in drug eluting bead TACE group, Partial response was achieved in 11 cases (45.8%) in c TACE group, and in 8 cases (50 %) in DEBs-TACE group, Cases with stable disease were 5 cases (20.8%) in c TACE group, and it was 3 cases (18.7%) in DEBs-TACE group, progressive disease is noted in two cases (8.3 %) in c TACE group, and one case (6.2 %) in drug eluting TACE group. Complications were as follow: 18 cases (75%) with abdominal pain in c TACE group, and 6 cases (37.5%) with abdominal pain in DEBs-TACE group, Nausea and vomiting were noted in 13 cases (54.17%) in c TACE group and in 3 cases (18.75%)in DEBs TACE group, Alopecia was noted in 8 cases (33.3 %) in c TACE group and in one case (6.25%) in DEBs TACE group.There were no significant differences between two groups regarding tumour response after 1 month. Almost all complications were significantly lower in DEBs-TACE group than in c TACE group, especially with abdominal pain, nausea, vomiting and alopecia. Abbreviations: c TACE: conventional trans-arterial chemoembolization, DEB TACE: drug eluting beads trans-arterial chemoembolization, HCC: hepatocellular carcinoma, CR: complete response, PR: partial response, SD: stable disease, PD: progressive disease.

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A randomized phase II trial of a drug eluting bead in the treatment of hepatocellular carcinoma by transcatheter arterial chemoembolization

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.4523 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 4523-4523 ◽

Cited By ~ 2

Author(s):

R. Lencioni ◽

K. Malagari ◽

T. Vogl ◽

F. Pilleul ◽

A. Denys ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Response ◽

Transcatheter Arterial Chemoembolization ◽

Objective Response ◽

Intermediate Stage ◽

Curative Treatment ◽

Tace Group ◽

Conventional Tace ◽

Drug Eluting ◽

Arterial Chemoembolization

4523 Background: Transcatheter arterial chemoembolization (TACE) has been shown to offer a survival benefit for patients with intermediate-stage hepatocellular carcinoma (HCC). A widely accepted TACE regimen includes the administration of a doxorubicin-in-oil emulsion followed by gelatine sponge particles. Recently, a drug-eluting bead (DEB) has been developed to enhance drug delivery to the tumor and reduce its systemic availability. Purpose of this randomized trial was to compare conventional TACE with DEB-TACE for the treatment of intermediate-stage HCC in patients with cirrhosis. Methods: Two hundred and twelve patients (185 males and 27 females; mean age, 67 years) with Child-Pugh A or B liver cirrhosis and large and/or multinodular, unresectable HCC were randomized to receive DEB-TACE (DC Bead; Biocompatibles, UK) uploaded with doxorubicin or conventional TACE with doxorubicin, lipiodol, and gelatin sponge particles. Randomization was stratified according to Child Pugh status (A or B), performance status (ECOG 0 or 1), bilobar disease (yes or no) and prior curative treatment (yes or no). Tumor response at 6 months was the primary study endpoint. An independent, blinded review of magnetic resonance imaging studies was conducted to assess tumor response according to amended RECIST criteria. Results: DEB-TACE with doxorubicin showed a higher rate of complete response, objective response and disease control compared with conventional TACE (27% vs 22%; 52% vs 44%; and 63% vs 52%, respectively; p>0.05). Patients with Child Pugh B, ECOG 1, bilobar disease and recurrence following curative treatment showed a significant increase in objective response (p=0.038) compared to the control. There was a marked reduction in serious liver toxicity in patients treated with DEB-TACE. The rate of doxorubicin related side effects was significantly lower (p=0.0001) in the DEB-TACE group compared with the conventional TACE group. Conclusions: DEB-TACE with doxorubicin is safe and effective in the treatment of intermediate-stage HCC and may offer benefit to patients with more advanced disease. No significant financial relationships to disclose.

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3:27 PM Abstract No. 301 Drug-eluting beads transcatheter arterial chemoembolization is effective and well-tolerated in hepatocellular carcinoma patients with portal vein tumor thrombus

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2019.12.354 ◽

2020 ◽

Vol 31 (3) ◽

pp. S138

Author(s):

J. Sun ◽

G. Zhou ◽

T. Zhou

Keyword(s):

Hepatocellular Carcinoma ◽

Portal Vein ◽

Tumor Thrombus ◽

Transcatheter Arterial Chemoembolization ◽

Portal Vein Tumor Thrombus ◽

Drug Eluting Beads ◽

Drug Eluting ◽

Arterial Chemoembolization

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Hemobilia immediately after transcatheter arterial chemoembolization using drug-eluting beads for hepatocellular carcinoma with intrahepatic bile duct invasion

Hepatology Research ◽

10.1111/hepr.12995 ◽

2017 ◽

Vol 48 (4) ◽

pp. 329-332 ◽

Cited By ~ 1

Author(s):

Maiko Nishi ◽

Issei Saeki ◽

Takahiro Yamasaki ◽

Masaki Maeda ◽

Takuro Hisanaga ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Bile Duct ◽

Transcatheter Arterial Chemoembolization ◽

Intrahepatic Bile Duct ◽

Drug Eluting Beads ◽

Drug Eluting ◽

Bile Duct Invasion ◽

Arterial Chemoembolization

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Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

BMC Cancer ◽

10.1186/s12885-019-6386-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Zi-shu Zhang ◽

Hui-zhou Li ◽

Cong Ma ◽

Yu-dong Xiao

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Size ◽

Tumor Response ◽

Liver Toxicity ◽

Objective Response ◽

Efficacy And Safety ◽

Tace Group ◽

Drug Eluting Beads ◽

Drug Eluting ◽

The Difference

Abstract Background To compare the efficacy and safety between conventional transarterial chemoembolization (cTACE) and drug-eluting beads TACE (DEB-TACE) in patients with infiltrative hepatocellular carcinoma (iHCC). Methods A total of 89 iHCC patients who were treated with either cTACE (n = 33) or DEB-TACE (n = 56) between April 2013 and September 2017 were included in this retrospective study. Patients with the situations that might have a poor outcome were defined as advanced disease including Child-Pugh class B, bilobar lesions, tumor size greater than 10 cm, ECOG 1–2, tumor burden of 50–70%, and the presence of ascites, arterioportal shunt (APS), and portal venous tumor thrombus (PVTT). The tumor response was measured 1-month and 3-month after the procedure. Progression-free survival (PFS) was calculated. Toxicity was graded by Common Terminology Criteria for Adverse Events v5.0 (CTCAE v5.0). The differences in tumor response, PFS, and toxicity were compared between the DEB-TACE group and cTACE group. Results At 1-month and 3-month after the procedure, the objective response rate (ORR) in the overall study population was similar in DEB-TACE group and cTACE group. The disease control rate (DCR), at 1-month after the procedure, was significantly higher in the patients treated with DEB-TACE relative to those treated with cTACE (P = 0.034), while after 3 months, the difference did not differ between two groups. DEB-TACE showed a higher DCR than cTACE in patients with tumor size greater than 10 cm (P = 0.036) or associated with APS (P = 0.030) at 1-month after the procedure, while after 3 months, the difference was only noted in patients with APS (P = 0.036). The median PFS in DEB-TACE group was 96 days, while in cTACE group was 94 days, and there was no difference in PFS between two groups (P = 0.831). In the side effect analysis, abdominal pain (P = 0.034) and fever (P = 0.009) were more frequently present in the cTACE group than DEB-TACE group, but there was no difference in high grade liver toxicity between the two groups. Conclusions Compared to cTACE, DEB-TACE offers slightly better DCR and tolerability for iHCC patients, particularly in patients associated with APS and large tumor size. However, DEB-TACE does not provide higher PFS than cTACE.

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Evaluation of drug-eluting beads versus conventional transcatheter arterial chemoembolization in patients with unresectable hepatocellular carcinoma: A systematic review and meta-analysis

Clinics and Research in Hepatology and Gastroenterology ◽

10.1016/j.clinre.2016.05.013 ◽

2017 ◽

Vol 41 (1) ◽

pp. 75-85 ◽

Cited By ~ 17

Author(s):

Peng Chen ◽

Peng Yuan ◽

Bo Chen ◽

Jingchang Sun ◽

Hang Shen ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Transcatheter Arterial Chemoembolization ◽

Meta Analysis ◽

Unresectable Hepatocellular Carcinoma ◽

Drug Eluting Beads ◽

Drug Eluting ◽

Arterial Chemoembolization

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Conventional Transarterial Chemoembolization Versus Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Cancers ◽

10.3390/cancers13246172 ◽

2021 ◽

Vol 13 (24) ◽

pp. 6172

Author(s):

Khalid I. Bzeizi ◽

Mohammad Arabi ◽

Negar Jamshidi ◽

Ali Albenmousa ◽

Faisal M. Sanai ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Partial Response ◽

Transcatheter Arterial Chemoembolization ◽

Objective Response ◽

Pooled Analysis ◽

All Cause Mortality ◽

Drug Eluting Beads ◽

Drug Eluting ◽

Tace Treatment ◽

Arterial Chemoembolization

Hepatocellular carcinoma (HCC) occurs in nearly three-quarters of all primary liver cancers, with the majority not amenable to curative therapies. We therefore aimed to re-evaluate the safety, efficacy, and survival benefits of treating patients with drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) compared to the conventional transcatheter arterial chemoembolization (C-TACE). Several databases were searched with a strict eligibility criterion for studies reporting on adult patients with unresectable or recurrent HCC. The pooled analysis included 34 studies involving 4841 HCC patients with a median follow-up of 1.5 to 18 months. There were no significant differences between DEB-TACE and C-TACE with regard to complete response, partial response and disease stability. However, disease control (OR: 1.42 (95% CI (1.03,1.96) and objective response (OR: 1.33 (95% CI (0.99, 1.79) were significantly more effective for DEB-TACE treatment with fewer severe complications and all-cause mortality. The pooled-analysis did not find superiority of DEB-TACE in complete or partial response, disease stability, controlling disease progression, and 30 day or end-mortality. However, results showed that DEB-TACE is associated with a better objective response, disease control, and lower all-cause mortality with severe complications compared to C-TACE treatment. Given that the safety outcomes are based on limited studies with a potential for bias, there was no clear improvement of DEB-TACE over C-TACE treatment.

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