Comparison of conventional transarterial chemoembolization (TACE) and chemoembolization with doxorubicin drug eluting beads (DEB) for unresectable hepatocelluar carcinoma (HCC)

Abstract

Background and Objectives Chemoembolization with doxorubicin drug eluting beads (DEB) is a novel locoregional treatment modality for unresectable hepatocellular carcinoma (HCC). Initial animal studies and clinical trials suggest that treatment with DEB may provide safer and more effective short‐term outcomes than conventional chemoembolization. Current study explores long‐term survival benefits. Methods Consecutive patients who received transcatheter therapy with DEB or conventional chemoembolization as sole therapy between 1998 and 2008 were studied. Statistical analysis was performed using Kaplan–Meier estimator with log‐rank testing, chi‐squared, and independent t‐tests. Results Seventy‐one patients were included in this study, 45 (63.4%) received therapy with DEB (group A) and 26 (36.6%) underwent conventional chemoembolization (group B). Median survival from diagnosis of HCC in groups A and B were 610 (351–868) and 284 days (4–563; P = 0.03), respectively. In Okuda stage I, survival in groups A and B were 501 (421–528) and 354 days (148–560, P = 0.02). In Child–Pugh classes A and B, survival in groups A and B were 641 (471–810) and 323 days (161–485, P = 0.002). Median survival in patients with Cancer of Liver Italian Program (CLIP) score ≤3 in groups A and B were 469 (358–581) and 373 days (195–551, P = 0.03). NCI CTCAEv3 Grade 5 clinical toxicity was similar. Conclusions In our study, transcatheter therapy with DEB offers a survival advantage over conventional chemoembolization for patients with unresectable HCC. J. Surg. Oncol. 2010; 101:476–480.