title: Use of Ethanol in the Trans-Arterial Lipiodol Embolization (TAELE) of Intermediated-Stage HCC: Is This Safer than Conventional Trans-Arterial Chemo-Embolization (c-TACE)?
abstract: OBJECTIVE
  To evaluate safety and efficacy of Trans-Arterial Ethanol-Lipiodol Embolization (TAELE) compared with conventional Trans-Arterial Chemo-Embolization (cTACE) in the treatment of small intermediate-HCC (BCLC-Stage B).
  
  
  METHODS
  A random sample of 87 patients (37.93% male; 62.07% female; age range, 36-86 years) with documented small intermediate-HCC and treated with TAELE (mixture 1:1 of Ethanol and Lipiodol) or cTACE (mixture of 50mg-Epirubicin and 5cc-Lipiodol) were retrospectively studied in an institutional review board approved protocol. The two procedures were compared with χ2-test, χ2-test with Yates correction, McNemar's exact test, ANOVA test and log-rank test.
  
  
  RESULTS
  TAELE and cTACE therapies were performed in 45 and 42 patients, respectively. Thirty days after the procedure, a Multi-Detector Computed Tomography (MDCT) showed no significant difference in the number of patients with partial and complete response between the two groups (p-value = 0.958), according to mRECIST. Contrary, significant differences were found in tumor-devascularization, lesion-reduction and post-embolization syndrome occurrence (p-value = 0.0004, p-value = 0.0003 and p-value = 0.009, respectively). Similar survival was observed during 36-month follow-up (p-value = 0.884).
  
  
  CONCLUSIONS
  Compared to cTACE, TAELE showed a better toxicity profile with similar 36-month survival and similar one-month anti-tumor effects, which makes it better tolerated by patients, especially in case of more than one treatment.
authors.affiliation: Department of Medicine and Surgery "Magrassi and Lanzara", Section of Radiology, Second University of Naples (SUN), Napoli, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Somma
authors.affiliation: Department of Interventional Radiology, National Cancer Institute of Naples "Fondazione Pascale", Napoli, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Angelo
authors.affiliation: Department of Medicine and Surgery "Magrassi and Lanzara", Section of Radiology, Second University of Naples (SUN), Napoli, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Serra
authors.affiliation: Department of Medicine and Surgery "Magrassi and Lanzara", Section of Radiology, Second University of Naples (SUN), Napoli, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gatta
authors.affiliation: Department of Medicine and Surgery "Magrassi and Lanzara", Section of Radiology, Second University of Naples (SUN), Napoli, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Grassi
authors.affiliation: Department of Interventional Radiology, National Cancer Institute of Naples "Fondazione Pascale", Napoli, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D015251:Epirubicin / Q000008:administration & dosage* / Q000627:therapeutic use; D000431:Ethanol / Q000008:administration & dosage* / Q000627:therapeutic use; D004998:Ethiodized Oil / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000431:Ethanol; D015251:Epirubicin; D004998:Ethiodized Oil