Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinoma

Background & Aims: Transarterial chemoembolization (TACE) is a widely used treatment for hepatocellular carcinoma. In order to maximize its therapeutic efficacy, doxorubicin-loaded drug-eluting beads have been developed to deliver higher doses of the chemotherapeutic agent and to prolong contact time with the tumor. The purpose of this study was to evaluate the efficacy and safety of drug-eluting bead (DC bead (R)) TACE in comparison with conventional TACE (cTACE). Methods: A total of 129 patients who underwent TACE between August 2008 and February 2011 were enrolled. We compared HCC patients who underwent TACE with DC bead (R) (n = 60) to controls who received cTACE (n = 69). The primary end points were treatment response and treatment-related adverse events. The secondary end point was time to progression. Results: The treatment response in the DC bead (R) group was significantly higher than that of the cTACE group (p <0.001). The time to progression was significantly better in the DC bead (R) group than in the cTACE group (11.7 and 7.6 months, respectively, p = 0.018). Subgroup analysis showed that in intermediate-stage HCC, DC bead (R) treatment resulted in a significantly better treatment response and longer time to progression than cTACE (p <0.001 and 0.038, respectively). However, there was no statistically significant difference in liver toxicity between the DC bead (R) and cTACE group (p >0.05). Conclusions: TACE with DC bead (R) showed better treatment response and delayed tumor progression compared with cTACE. There was no significant difference in hepatic treatment-related toxicities. DC bead (R) TACE thus appears to be a feasible and promising approach to the treatment of HCC. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.