title: Doxorubicin-loaded drug-eluting beads versus conventional transarterial chemoembolization for nonresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  To compare the efficacy and safety profile of doxorubicin-loaded drug-eluting beads (DEB) to the conventional TACE (C-TACE) in the management of nonresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  All patients with nonresectable HCC who underwent either c-TACE or DEB-TACE during the period 2006-2014 and fulfilled the inclusion criteria were included in this retrospective study. Primary endpoints were tumor response rate at first imaging follow up, treatment-related liver toxicity, and treatment emergent adverse events (TEAE).
  
  
  RESULTS
  Thirty-five patients (51 procedures) in the DEB-TACE group and 19 patients (25 procedures) in the c-TACE group were included in the analysis. The median follow up time was 61 days (range 24-538 days) in the DEB-TACE group and 86 days (range 3-152 days) for the c-TACE group patients. Complete response (CR), objective response (OR), disease control (DC), and progressive disease (PD) rates were 11%, 24%, 17%, and 47%, respectively, in the DEB = TACE group compared with 4%, 32%, 28%, and 36%, respectively, in the c-TACE group. Mean ALT change from baseline was minimal in the DEB-TACE patients compared with c-TACE group (7.2 vs 79.4 units, P = 0.001). Hospital stay was significantly shorter in the DEB-TACE group (7.8 days vs 11.4 days; P = 0.038). The 2-year survival rate was 60% for the c-TACE patients and 58% for the DEB-TACE (P = 0.4).
  
  
  CONCLUSIONS
  DEB-TACE compared with c-TACE is associated with lesser liver toxicity benefit, better tolerance, and shorter hospital stay. The two modalities however had similar survival and efficacy benefits.
authors.affiliation: Department of Medical Imaging, Division of Interventional Radiology, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arabi
authors.forename: Ali
authors.initials: A
authors.lastname: BenMousa
authors.forename: Khaled
authors.initials: K
authors.lastname: Bzeizi
authors.forename: Fares
authors.initials: F
authors.lastname: Garad
authors.forename: Ishtiaq
authors.initials: I
authors.lastname: Ahmed
authors.forename: Melfi
authors.initials: M
authors.lastname: Al-Otaibi
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008111:Liver Function Tests / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin