title: Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre.
  
  
  METHODS
  A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups.
  
  
  RESULTS
  A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were 4.9 ± 3.2 months and 8.3 ± 2.0 months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria.
  
  
  CONCLUSIONS
  DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.
authors.affiliation: Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Aziz, Kuala Lumpur, Malaysia E-mail : jeevinesh@gmail.com.
authors.forename: F Abdul
authors.initials: FA
authors.lastname: Rahman
authors.forename: J
authors.initials: J
authors.lastname: Naidu
authors.forename: C S
authors.initials: CS
authors.lastname: Ngiu
authors.forename: Y
authors.initials: Y
authors.lastname: Yaakob
authors.forename: Z
authors.initials: Z
authors.lastname: Mohamed
authors.forename: H
authors.initials: H
authors.lastname: Othman
authors.forename: R
authors.initials: R
authors.lastname: Jarmin
authors.forename: M H
authors.initials: MH
authors.lastname: Elias
authors.forename: N Abdul
authors.initials: NA
authors.lastname: Hamid
authors.forename: N Mohd
authors.initials: NM
authors.lastname: Mokhtar
authors.forename: Ra Raja
authors.initials: RR
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004317:Doxorubicin