Safety and Efficacy of 70-150 μm and 100-300 μm Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

Purpose: To compare the safety and efficacy of using 70-150 mu m drug-eluting beads (DEBs) (LC BeadM1; Biocompatibles UK Ltd, Farnham, Surrey, United Kingdom) in addition to 100-300 mu m DEBs with 100-300 mu m DEBs alone in transarterial chemoembolization for treatment of hepatocellular carcinoma (HCC). Materials and Methods: A cohort of patients with HCC who underwent transarterial chemoembolization with two vials of 100-300 mu m DEBs (group 1, 55 procedures among 42 patients, 33 men, average Model for End-Stage Liver Disease score 10 +/- 0.6, 67% Child-Pugh A, 33% Child-Pugh B) was retrospectively compared with a cohort of patients who underwent transarterial chemoembolization with one vial of 70-150 mu m DEBs followed by one vial of 100-300 mu m DEBs (group 2, 51 procedures among 42 patients, 29 men, average Model for End-Stage Liver Disease score 9 +/- 0.6; 73% Child-Pugh A, 27% Child-Pugh B) in regard to adverse events and response on 1-month follow-up imaging using modified Response Evaluation Criteria In Solid Tumors criteria. Results: There was no difference in 1-month imaging response (P= .3). Patients in group 2 were readmitted more often within 1 month for hepatobiliary adverse events (group 2, 25%; group 1, 9%; P < .0001), including ascites, gastrointestinal hemorrhage, biliary dilatation, and cholecystitis. Conclusions: Despite similar efficacy based on short-term follow-up imaging, transarterial chemoembolization with smaller DEBs (70-150 mu m) followed by larger DEBs (100-300 mu m) may cause more hepatobiliary adverse events.