title: Comparison of conventional transarterial chemoembolization (TACE) and chemoembolization with doxorubicin drug eluting beads (DEB) for unresectable hepatocelluar carcinoma (HCC).
abstract: OBJECTIVE
  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 I, 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 <or=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.
authors.affiliation: Division of Interventional Radiology and Image guided Medicine, Department of Radiology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Renumathy
authors.initials: R
authors.lastname: Dhanasekaran
authors.forename: David A
authors.initials: DA
authors.lastname: Kooby
authors.forename: Charles A
authors.initials: CA
authors.lastname: Staley
authors.forename: John S
authors.initials: JS
authors.lastname: Kauh
authors.forename: Vinit
authors.initials: V
authors.lastname: Khanna
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin