Comparison of Treatment Response and Survival Profiles Between Drug-Eluting Bead Transarterial Chemoembolization and Conventional Transarterial Chemoembolization in Chinese Hepatocellular Carcinoma Patients: A Prospective Cohort Study

Abstract

This study evaluated the difference in treatment response and survival profiles between drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) treatments in Chinese hepatocellular carcinoma (HCC) patients. A total of 120 HCC patients were consecutively enrolled in this prospective cohort study, which showed that DEB-TACE achieved higher complete response (CR) (30.8%) compared with cTACE (7.4%) with no difference in overall response rate (ORR) for patients treated with DEB-TACE and cTACE (80.8% vs. 73.5%). In addition, DEB-TACE was associated with a lower rate of progressive disease (PD) compared with cTACE (1.9% vs. 11.8%). With respect to survival, patients in the DEB-TACE group achieved median progression-free survival (PFS) of 15 months (95% CI 12‐18 months), which was longer than the cTACE group [median PFS 11 months (95% CI 10‐12 months)]. Median overall survival (OS) was also longer with DEB-TACE [25 months (95% CI 22-28 months)] when compared with cTACE [21 months (95% CI 18‐24 months)]. Univariate and multivariate logistic regression analysis showed that DEB-TACE was an independent predictive factor for achieving CR. Univariate Cox’s regression analysis revealed that DEB-TACE was a predictive factor for prolonged PFS and OS, while multivariate analysis demonstrated that DEB-TACE was not an independent factor for predicting PFS or OS. In conclusion, we found that DEB-TACE achieved higher treatment response and prolonged survival compared with cTACE in Chinese HCC patients.

Drug-Eluting Bead Transarterial Chemoembolization versus Conventional Transarterial Chemoembolization Both Combined Apatinib for Hepatocellular Carcinoma: A Retrospective, Propensity-Score Matched Study

“…The results suggested that compared with cTACE treatment, DEB-TACE treatment attained a higher ORR and longer long-term survival time. 8 Nevertheless, regardless of cTACE or DEB-TACE treatment, permanent chemoembolization cannot destroy these tumor lesions, and the ischemic and hypoxic microenvironment caused by TACE easily motivates neovascularization in local tumors.…”

Drug-Eluting Beads Bronchial Arterial Chemoembolization in Treating Relapsed/Refractory Small Cell Lung Cancer Patients: Results from a Pilot Study

“…Generally, DEB-TACE is predominantly applied in liver cancers and metastatic tumor in the liver; however, in recent years, increasing studies disclose that it could also be utilized in other solid tumors. [9][10][11][12] Most importantly, in regard to its application in lung cancers or metastasis to the lung, a prior study reveals that in six NSCLC patients who are not able to receive standard treatment, the ORR and DCR are respectively 50.0% and 100.0% at 2 months, 50.0% and 83.3% at 4 months, 50.0% and 66.7% at 6 months post DEB-BACE treatment. 23 Another study elucidates that in 52 patients with lung metastasis from other solid tumors, the DEB-BACE treatment achieves PR, SD and PD of 30.8%, 21.2% and 48.0%, respectively.…”

“…9,10 DEB-TACE presents with many advantages in the clinical setting, such as a better response rate and improvement in reducing systemic toxicity induced by chemotherapeutics, when compared to the traditional TACE in treating liver cancer patients. 11,12 Interestingly, besides liver cancers, DEB-TACE is also reported to be effective and tolerable in other solid tumors. As an example, it is reported that DEB-TACE shows comparable efficacy, more favorable tolerance, increased resection rate and less financial cost as downstaging therapy in cervical cancer patients compared to synchronous radiochemotherapy.…”

Thermal ablation combined with transarterial chemoembolization for hepatocellular carcinoma: What is the right treatment sequence?

“…After cTACE, lipiodol causes visualization of the targeted lesion on a non-contrast CT-scan, which may help needle positioning when TA is performed after TACE. Although limited evidence suggests DEB-TACE may yield better local control when used as single therapy [18,19], the influence of different TACE techniques when combined with TA has not been studied. Further research is warranted to determine how synergy between TA and TACE is best achieved.…”