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Role of drug-eluting beads versus conventional transarterial chemoembolization in the treatment of hepatocellular carcinoma

2019; Medknow; Volume: 17; Issue: 1 Linguagem: Inglês

10.4103/azmj.azmj_4_19

2536-9652

M.D. MOHAMED ABDEL MENAEM SAYED FAROUK MOHAMED, MahmoudAbu Elfadl, Mohamed S.Abdelaziz Shehata, AhmedS Elskaan,

Cancer Mechanisms and Therapy

Background Transarterial chemoembolization has become the current standard therapy for the intermediate-stage hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer staging system. Conventional transarterial chemoembolization (cTACE) involves the injection of an embolic agent into the tumor-feeding arteries to block its major nutrient source resulting in tumor ischemic necrosis. Drug-eluting beads transarterial chemoembolization (DEB-TACE) was developed to deliver higher doses of chemotherapeutic agents over longer drug-tumor contact times.Objective The aim of this study was to highlight on the safety and efficacy of DEB-TACE versus cTACE in patients with intermediate-stage HCC.Patients and methods This study was carried out on 55 patients presented with irresectable who HCC underwent either cTACE: group 1, 25 patients or DEB-TACE; group 2, 30 patients from July 2016 to June 2017. All patients were subjected to full history taking, thorough clinical examination, investigations, imaging, adequate follow-up at 1, 3, and 6 months and were categorized according to the modified Response Evaluation Criteria in Solid Tumors.Results According to the modified Response Evaluation Criteria in Solid Tumors responding disease was seen in 28 patients who underwent DEB-TACE and 18 who patients underwent cTACE, while nonresponding disease was found in two patients who underwent DEB-TACE and seven patients underwent cTACE (P=0.033). Complications such as postembolization syndrome and ascites occurs more in patients who underwent cTACE than after DEB-TACE (P=0.04, P=0.61).Conclusion DEB-TACE is more effective than cTACE in intermediate-stage HCC with less side effects.