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Conventional Versus Small Doxorubicin-eluting Bead Transcatheter Arterial Chemoembolization for Treating Barcelona Clinic Liver Cancer Stage 0/A Hepatocellular Carcinoma

CardioVascular and Interventional Radiology volume 43, pages 55–64 (2020)Cite this article

Abstract

Purpose

Approximately, 60–70% of patients with early-stage hepatocellular carcinoma (HCC) globally are ineligible for the recommended first-line procedures. This study aimed to compare conventional transcatheter arterial chemoembolization (cTACE) with a treatment, small drug-eluting bead TACE (DEB-TACE), in patients with stage 0/A HCCs.

Materials and Methods

We retrospectively investigated 76 patients who underwent first-time cTACE (n = 40) or DEB-TACE using 75–150 µm DC Beads® (n = 36) for Barcelona Clinic Liver Cancer (BCLC) stage 0/A HCC < 3 cm at a single tertiary care center between July 2015 and March 2017. Outcome measurements were time to local progression (assessed per modified response evaluation criteria in solid tumors), tumor response at one month and intrahepatic distal recurrence, progression-free survival, overall survival, safety, and toxicity.

Results

The study included 60 (78%) men and 16 (21%) women; participant mean age was 65.8 years. Objective response rates between the cTACE and DEB-TACE groups were similar (p > 0.05). Complete and partial 1-month tumor response rates were 60.0% and 22.5%, respectively, in the cTACE group and 69.4% and 25.0%, respectively, in the DEB-TACE group. The abdominal pain grade was significantly lower with DEB-TACE than with cTACE (p = 0.001). AST and ALT levels after tumor treatment with DEB-TACE were significantly lower than those after treatment with cTACE (p = 0.018 and 0.006). Time to local progression, intrahepatic distal recurrence, progression-free survival, and overall survival were not significantly between the DEB-TACE group and the cTACE group (p > 0.05).

Conclusion

Time to local progression between groups was not significantly different; however, post-embolic syndrome occurred less frequently in the DEB-TACE group. DEB-TACE appears to be a feasible treatment for small HCCs.

Level of Evidence

Level 3.

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Funding

This study was not supported by any funding.

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Affiliations

  1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea

    Yang Jun Kang, Byung Chan Lee & Yong Yeon Jeong

  2. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Hwasun-gun, Jeollanam-do, Republic of Korea

    Jae Kyu Kim, Nam Yeol Yim & Hyoung Ook Kim

  3. Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Soo Buem Cho

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Contributions

YYJ and YJK conceived and conducted the study, and BCL and HOK performed the analyses, the interpretation of results, and the drafting of the manuscript. YJK and SBC collected the data and conducted the study and assisted with interpretation of results and drafting of the manuscript. YYJ, NYI, and JKK assisted with the analyses, the interpretation of results, and drafting of the manuscript.

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Correspondence to Yong Yeon Jeong.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Kang, Y.J., Lee, B.C., Kim, J.K. et al. Conventional Versus Small Doxorubicin-eluting Bead Transcatheter Arterial Chemoembolization for Treating Barcelona Clinic Liver Cancer Stage 0/A Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 43, 55–64 (2020). https://doi.org/10.1007/s00270-019-02349-9

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Keywords

  • Hepatocellular carcinoma
  • Conventional transcatheter arterial chemoembolization
  • Drug-eluting bead transcatheter arterial chemoembolization
  • Drug-eluting beads
  • Adverse event