title: Trans-arterial chemoembolization with doxorubicin-eluting particles versus conventional trans-arterial chemoembolization in unresectable hepatocellular carcinoma: A study of effectiveness, safety and costs.
abstract: OBJECTIVE
  To compare the effectiveness, survival and cost in patients with unresectable hepatic cell carcinoma (HCC) treated with trans-arterial chemoembolization using doxorubicin-eluting beads (DEB-TACE) versus conventional TACE (cTACE) in clinical practice.
  
  
  METHODS
  This single-centered retrospective observational study compared 60 consecutive HCC unresectable patients: 30 were treated with DEB-TACE and 30 used cTACE. Comparisons were with χ(2) test, Student t-test, and Kaplan Meier method.
  
  
  RESULTS
  Of the 60 patients with HCC in non-curative stage, baseline characteristics were similar for both groups of treatment, and of these we observed lower survival in male patients and those who had hepatitis C virus (p=0.014 and p=0.003, respectively). No statistically significant differences were observed as a function of treatment employed with respect to overall survival (OS) at 5 years (29.99 months; 95%CI: 21.38-38.60 versus 30.67 months; 95%CI:22.65-38.70; p=0.626) and progression free survival (PFS) median of 11.57 months (95%CI: 0.97-22.18) versus 12.80 months (95%CI:0.00-32.37; p=0.618). The median length of hospital admission were 2.6 and 5.4 days (p<0.001) for DEB(-)TACE and cTACE, respectively. Toxicities grade 2-4 were higher in cTACE group (54 versus 31; p<0.001). The cost of the treatment was 1581 € for DEB(-)TACE and 514.63 € for cTACE. The overall mean cost of intervention was 3134 € and 3694.35 €, respectively (p=0.173).
  
  
  CONCLUSIONS
  Chemoembolization in patients with unresectable HCC achieved OS close to 30 months at 5 years, independent of the technique employed. Similar overall costs but better tolerance of the DEB-TACE justified the higher costs of the procedure.
authors: Department of Pharmacy, Drug Clinical Area, Hospital Universitari i Politècnic La Fe and Instituto de Investigación Sanitaria La Fe, Valencia, Spain. Electronic address: megias_jua@gva.es.
authors: J E
authors: JE
authors: Megías Vericat
authors: Department of Radiology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: R
authors: R
authors: García Marcos
authors: Department of Pharmacy, Drug Clinical Area, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: E
authors: E
authors: López Briz
authors: Department of Radiology, Hospital Clinic, Barcelona, Spain.
authors: F
authors: F
authors: Gómez Muñoz
authors: Department of Pharmacy, Drug Clinical Area, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: J
authors: J
authors: Ramos Ruiz
authors: Department of Radiology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: J J
authors: JJ
authors: Martínez Rodrigo
authors: Department of Pharmacy, Drug Clinical Area, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: J L
authors: JL
authors: Poveda Andrés
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D016461:Chemoembolization, Therapeutic; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D004317:Doxorubicin
keywords: Carcinoma hepatocelular irresecable; Cost; Coste; Doxorubicin-eluting beads; Efectividad; Effectiveness; Partículas liberadoras de doxorrubicina; Quimioembolización transarterial; Survival; Toxicidad; Toxicity; Trans-arterial chemoembolization; Unresectable hepatic cell carcinoma; supervivencia