Effectiveness of drug-eluting bead transarterial chemoembolization versus conventional transarterial chemoembolization for small hepatocellular carcinoma in Child-Pugh class A patients. (August 2019)

• Record Type: Journal Article
• Authors: Lee, In Joon; Lee, Jeong-Hoon; Lee, Yun Bin; Kim, Yoon Jun; Yoon, Jung-Hwan; Yin, Yong Hu; Lee, Myungsu; Hur, Saebeom; Kim, Hyo-Cheol; Jae, Hwan Jun; Chung, Jin Wook
• Is Part Of: Therapeutic advances in medical oncology. Volume 11(2019)
• Publication Date: 2019-08
• Subjects: drug-eluting bead -- hepatocellular carcinoma -- transarterial chemoembolization; Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.994005
• DOI: 10.1177/1758835919866072
• Languages: English
• ISSNs: 1758-8340

Abstract

Background: This study aimed to compare the therapeutic effectiveness including progression-free survival (PFS), overall survival (OS), and safety of conventional transarterial chemoembolization (cTACE) and drug-eluting bead transarterial chemoembolization (DEB-TACE) in a superselective fashion for the patients with nodular hepatocellular carcinoma (HCC) ( n ⩽ 5) and Child–Pugh class A. Methods: A total of 198 consecutive patients with nodular HCCs ( n ⩽ 5) and Child–Pugh class A liver function who were initially treated with cTACE ( n = 125) or DEB-TACE ( n = 57) were included retrospectively. The primary endpoint was PFS. Secondary endpoints included time-to-target lesion progression (TTTLP), OS, and safety. Results: The median follow up was 62 months (range, 1–87 months). The PFS was significantly longer in the cTACE group than in the DEB-TACE group (median, 18 months versus 7 months; hazard ratio [HR] = 0.658, log-rank p = 0.031), whereas OS was comparable (log-rank p = 0.299). TTTLP was significantly longer in the cTACE group than in the DEB-TACE group (median, 34 months versus 11 months; log-rank p < 0.001). In the stratification analysis based on tumor size, the cTACE group showed significantly longer TTTLP than the DEB-TACE group in the 1.0–2.0 cm and 2.1–3.0 cm subgroups (HR = 0.188, log-rank p < 0.001 and HR = 0.410, p = 0.015, respectively) but not in the 3.1–5.0 cm and 5.1–10.0 cm subgroups (all p > 0.05). Postembolization syndrome occurred more frequently in the cTACE group than in the DEB-TACE group ( p = 0.006). Conclusions: DEB-TACE is followed by significantly shorter PFS than cTACE in patients with nodular HCCs ( n ⩽ 5) and Child–Pugh class A, although OS is comparable. Postembolization syndrome occurs more frequently in cTACE than in DEB-TACE.