title: Safety and efficacy of 70-150 μm and 100-300 μm drug-eluting bead transarterial chemoembolization for hepatocellular carcinoma.
abstract: OBJECTIVE
  To compare the safety and efficacy of using 70-150 μm drug-eluting beads (DEBs) (LC BeadM1; Biocompatibles UK Ltd, Farnham, Surrey, United Kingdom) in addition to 100-300 μm DEBs with 100-300 μm DEBs alone in transarterial chemoembolization for treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  A cohort of patients with HCC who underwent transarterial chemoembolization with two vials of 100-300 μm DEBs (group 1, 55 procedures among 42 patients, 33 men, average Model for End-Stage Liver Disease score 10 ± 0.6, 67% Child-Pugh A, 33% Child-Pugh B) was retrospectively compared with a cohort of patients who underwent transarterial chemoembolization with one vial of 70-150 μm DEBs followed by one vial of 100-300 μm DEBs (group 2, 51 procedures among 42 patients, 29 men, average Model for End-Stage Liver Disease score 9 ± 0.6, 73% Child-Pugh A, 27% Child-Pugh B) in regard to adverse events and response on 1-month follow-up imaging using modified Response Evaluation Criteria In Solid Tumors criteria.
  
  
  RESULTS
  There was no difference in 1-month imaging response (P = .3). Patients in group 2 were readmitted more often within 1 month for hepatobiliary adverse events (group 2, 25%; group 1, 9%; P < .0001), including ascites, gastrointestinal hemorrhage, biliary dilatation, and cholecystitis.
  
  
  CONCLUSIONS
  Despite similar efficacy based on short-term follow-up imaging, transarterial chemoembolization with smaller DEBs (70-150 μm) followed by larger DEBs (100-300 μm) may cause more hepatobiliary adverse events.
authors.affiliation: Division of Vascular & Interventional Radiology, Department of Radiology, New York University Medical Center, New York, New York.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Deipolyi
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Oklu
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School.
authors.forename: Shehab
authors.initials: S
authors.lastname: Al-Ansari
authors.affiliation: Massachusetts General Hospital Cancer Center, Department of Internal Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 290, Boston, MA 02114.
authors.forename: Andrew X
authors.initials: AX
authors.lastname: Zhu
authors.affiliation: Massachusetts General Hospital Cancer Center, Department of Internal Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 290, Boston, MA 02114.
authors.forename: Lipika
authors.initials: L
authors.lastname: Goyal
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School. Electronic address: sganguli@partners.org.
authors.forename: Suvranu
authors.initials: S
authors.lastname: Ganguli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003692:Delayed-Action Preparations / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010316:Particle Size; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003692:Delayed-Action Preparations; D006490:Hemostatics; D004998:Ethiodized Oil