Comparison of doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE) with conventional transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma

Objective: To compare conventional transarterial chemoembolization (TACE) with doxorubicineluting bead transarterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma, evaluating the tumor response, complications after treatment, and survival. Material and methods: We present 72 patients diagnosed with hepatocellular carcinoma treated consecutively between January 2000 and December 2009. We studied 25 patients treated with TACE (Group A) and 47 patients treated with DEB-TACE (Group B); adriamycin (doxorubicin) was the chemotherapy agent used in both groups. All patients had compensated cirrhosis of the liver classified on the Child-Pugh score. The results were analyzed according to the RECIST criteria. Statistical analyses consisted of ANOVA, chi-square tests, Student's t-tests, and Kaplan-Meier log-rank tests. Results: Patient's age, tumor size, number of tumors, and hepatic reserve were similar in the two groups. The mean number of sessions per patient was 1.32 +/- 0.67 in Group A versus 2.13 +/- 0.95 in Group B. The mean dose of adriamycin per patient was 50.60 +/- 29.95 mg in Group A and 231.91 +/- 110.2 mg in Group B. A complete response of the tumor to treatment was observed in 5.6% of the patients in Group A and in 13.9% of those in Group B. According to the RECIST criteria, no significant differences were found. DEB-TACE was better tolerated and had fewer immediate complications (p = 0.001). No significant differences were found in the survival of patients in the two groups (Group A: mean 686.24 days, median 709 days; Group B: mean 765.32 days, median 672 days. Conclusion: In patients with unresectable hepatocellular carcinoma, DEB-TACE is safe and better tolerated than conventional TACE; moreover, it seems to lead to greater necrosis of the tumors. (C) 2010 SERAM. Published by Elsevier Espana, S.L. All rights reserved.