title: Safety and efficacy of trans arterial chemoembolization with drug-eluting beads in hepatocellular cancer: a systematic review.
abstract: OBJECTIVE
  The aim of this review was to compare current conventional TACE to the drug eluting beads loaded with doxorubicin (DEBDOX) device in the treatment of HCC.
  
  
  METHODS
  A recent hepatocellular consensus discussion was convened to review all recent and past literature in the use of hepatic directed therapies to compare the safety, efficacy and overall survival of the available hepatic directed therapies in the management of hepatocellular cancer. A review of all publications in peer review journals in the English Language from 1995 to 2007 was performed.
  
  
  RESULTS
  The DEBDOX are an effective therapy with a favorable pharmacokinetic profile with significantly less systemic doxorubicin exposure when compared to conventional TACE. The DEBDOX had a significant (p<0.05) advantage in objective response in the more advanced patients (defined as Child-Pugh B, ECOG 1, recurrent disease and bilobar disease; p=0.038) and overall disease control in the more advanced patients (p=0.026). The DEBDOX Bead was also found to have a highly significant (p<0.01) advantage in the reduction of doxorubicin associated side effects (p=0.0001) in all patients.
  
  
  CONCLUSIONS
  The current collective data on the use of DEBDOX Bead in HCC patients provides sufficient evidence to support its use as a safe and effective chemo-embolic treatment in intermediate HCC patients. There is growing evidence to support the its use is superior to conventional doxorubicin TACE.
authors.affiliation: Department of Surgery, University of Louisville, KY, USA. rcmart03@gwise.louisville.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Martin
authors.forename: David
authors.initials: D
authors.lastname: Geller
authors.forename: Joseph
authors.initials: J
authors.lastname: Espat
authors.forename: David
authors.initials: D
authors.lastname: Kooby
authors.forename: Marty
authors.initials: M
authors.lastname: Sellars
authors.forename: Robert
authors.initials: R
authors.lastname: Goldstein
authors.forename: David
authors.initials: D
authors.lastname: Imagawa
authors.forename: Charles
authors.initials: C
authors.lastname: Scoggins
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004337:Drug Carriers; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008863:Microspheres; D053758:Nanoparticles; D010316:Particle Size; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004337:Drug Carriers; D004317:Doxorubicin