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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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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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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DOI: https://doi.org/10.1007/s00270-019-02349-9