Comparison of Conventional Transarterial Chemoembolization (TACE) and Chemoembolization With Doxorubicin Drug Eluting Beads (DEB) for Unresectable Hepatocelluar Carcinoma (HCC)

Background and Objectives: Chemoembolization with doxorubicin drug eluting beads (DEB) is a novel locoregional treatment modality for unresectable hepatocellular carcinoma (HCC). Initial animal studies and clinical trials suggest that treatment with DEB may provide safer and more effective short-term outcomes than conventional chemoembolization. Current study explores long-term survival benefits. Methods: Consecutive patients who received transcatheter therapy with DEB or conventional chemoembolization as sole therapy between 1998 and 2008 were studied. Statistical analysis was performed using Kaplan-Meier estimator with log-rank testing, chi-squared, and independent t-tests. Results: Seventy-one patients were included in this study, 45 (63.4%) received therapy with DEB (group A) and 26 (36.6%) underwent conventional chemoembolization (group B). Median survival from diagnosis of HCC in groups A and B were 610 (351-868) and 284 days (4-563; P = 0.03), respectively. In Okuda stage 1, survival in groups A and B were 501 (421-528) and 354 days (148-560, P = 0.02). In Child-Pugh classes A and B, survival in groups A and B were 641 (471-810) and 323 days (161-485, P = 0.002). Median survival in patients with Cancer of Liver Italian Program (CLIP) score <= 3 in groups A and B were 469 (358-581) and 373 days (195-551, P = 0.03). NCI CTCAEv3 Grade 5 clinical toxicity was similar. Conclusions: In our study, transcatheter therapy with DEB offers a survival advantage over conventional chemoembolization for patients with unresectable HCC. J. Surg. Oncol. 2010;101:476-480. (C) 2010 Wiley-Liss, Inc.