title: Nine-year experience of doxorubicin-eluting beads chemoembolization for hepatocellular carcinoma.
abstract: BACKGROUND
  Chemoembolization with doxorubucin-eluting beads (DEB) has been used to treat hepatocellular carcinoma (HCC) since 2007. This study compared the efficacy and survival between transarterial chemoembolization (TACE) with DEB and conventional approach (cTACE) in HCC treatment.
  
  
  METHODS
  This retrospective case-control study compared the overall survival and tumor response of HCC patients to cTACE (n=190) and DEB (n=143) by the reassessment of computed tomography and serum alpha-fetoprotein (AFP). Multivariate analysis was used to determine the factors affecting tumor response.
  
  
  RESULTS
  The median post-treatment to pre-treatment AFP level was 0.8 for a DEB session (n=258) and 1.0 for a cTACE session (n=452), showing a significantly greater decrease in AFP after DEB (P<0.05). More patients in the DEB group achieved objective response (complete and partial) compared with those in the cTACE group (P<0.05). Objective tumor response after DEB vs cTACE was 34.8% vs 15.4% in 0-3 months (P=0.001), 37.1% vs 20.0% in 3-6 months (P<0.05), and 50.0% vs 30.0% in 6-12 months (P=0.093). DEB predicted a 3.604 times odds of achieving at least one objective tumor response in a patient when compared to cTACE (P<0.0001). The median survival from first transcatheter therapy of patients having undergone at least once DEB was 12.53 months, while those having received cTACE only was 10.53 months (P=0.086). A tendency of improved survival appeared to maintain until >80 months after the first TACE session in the DEB group.
  
  
  CONCLUSIONS
  DEB is a safe alternative to cTACE in HCC patients with better therapeutic efficacy.
authors.affiliation: Department of Surgery, University of Hong Kong and Queen Mary Hospital, 102 Pok Fu Lam Rd, Pok Fu Lam, Hong Kong, China. cheung_hokwan@hotmail.com.
authors.forename: Alvin Ho-Kwan
authors.initials: AH
authors.lastname: Cheung
authors.forename: Colin Siu-Chi
authors.initials: CS
authors.lastname: Lam
authors.forename: Henry Shiu-Cheung
authors.initials: HS
authors.lastname: Tam
authors.forename: Tan-To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Roberta
authors.initials: R
authors.lastname: Pang
authors.forename: Ronnie Tung-Ping
authors.initials: RT
authors.lastname: Poon
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D016009:Chi-Square Distribution; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006723:Hong Kong; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000903:Antibiotics, Antineoplastic; D000509:alpha-Fetoproteins; D004317:Doxorubicin