Transcatheter embolization of hepatocellular carcinoma with epirubicin-loaded DC beads in Chinese patients

Guan-Hui Zhou, Jun-Hui Sun, Yue-Lin Zhang, Tan-Yang Zhou, Chun-Hui Nie, Tong-Yin Zhu, Jing Ai, Sheng-Qun Chen, Bao-Quan Wang, Zi-Niu Yu, Hong-Liang Wang, Li-Ming Wu, Li-Ming Chen, Shu-Sen Zheng


Background: This study evaluated the safety and efficacy of transcatheter chemoembolization with drug eluting beads (DEB-TACE) and compared it to the conventional TACE (cTACE) therapy method for hepatocellular carcinoma (HCC) in Chinese patients.
Methods: Seventy-four patients were treated with DEB-TACE using the DC bead, and 80 patients were treated with cTACE for HCC. The modified response evaluation criteria in solid tumors (mRECIST) criteria were used to evaluate clinical response, with adverse events assessed according to the Common Terminology Criteria for Adverse Events (CTCAE).
Results: Post-TACE, 9 patients (12.2%) achieved complete response (CR) and 44 (59.5%) achieved partial response (PR), with an overall tumor response rate (ORR) of 71.6% in the DEB-TACE group. Twelve patients (15%) achieved CR, and 38 (47.5%) achieved PR, with an ORR of 62.5% in the cTACE group. However, there was no significant difference in ORR between the two groups (P=0.229). Univariate logistic regression analysis determined that more than 3 nodules, higher Barcelona clinic liver cancer (BCLC) stage, portal vein invasion, previous chemotherapy (cTACE), and previous surgery were correlated with a worse ORR. Most common adverse events were not severe.
Conclusions: DEB-TACE by DC bead was efficient and well-tolerated compared to cTACE in Chinese HCC patients. However, the present study showed no significant difference in ORR between the DEB-TACE and cTACE in the patient group with HCC. The BCLC stage, number of nodules, portal vein invasion, cTACE, and surgery history could possibly be a predictive factor for HCC treatment response.