Hepatocellular carcinoma(HCC)is one of the most common types of malignant tumor.Although radical surgery and liver transplantation are possible cures for the disease,most patients are beyond the optimum stage for radi...Hepatocellular carcinoma(HCC)is one of the most common types of malignant tumor.Although radical surgery and liver transplantation are possible cures for the disease,most patients are beyond the optimum stage for radical treatment at the time of diagnosis.Transarterial chemoembolization(TACE)is the first choice of treatment for advanced HCC.Owing to the widespread use of conventional TACE(cTACE),the problems with this treatment cannot be ignored.Drug-eluting beads(DEBs),a new type of embolization material,appear to overcome the problems of cTACE,and they have other advantages such as synchronous controlled continuous drug release after chemotherapy and embolization and low blood concentrations after treatment.This review summarizes the recent advances in the use of DEB-TACE to treat HCC.展开更多
Objective:To compare the safety of conventional transarterial chemoembolization(cTACE)vs drug-eluting bead TACE(DEB-TACE)in very early-and early-stage hepatocellular carcinoma(HCC).Methods:Data of patients with early-...Objective:To compare the safety of conventional transarterial chemoembolization(cTACE)vs drug-eluting bead TACE(DEB-TACE)in very early-and early-stage hepatocellular carcinoma(HCC).Methods:Data of patients with early-and very early-stage HCC treated with cTACE or DEB-TACE were evaluated retrospectively in this study.A total of 40 patients were included,20 treated with cTACE and 20 with DEB-TACE.The cTACE and DEB-TACE groups were comprised of 80%and 75%males,while there were 20%females in cTACE group and 25%in Deb-TACE group respectively.The mean age of patients in cTACE group was 57.43+5.6 years,while it was 56.4+5.5 years in DEB-TACE group.All patients had liver status of Child–Pugh Class A and a score≤7 in Child-Pugh class type B in very early-(stage 0)or early-phase(stage A)stages according to the Barcelona Clinic Liver Cancer(BCLC)system.Results:The Child-Pugh class degradation in the cTACE group was slightly higher than that in the DEB-TACE group.Serious complications like peritumoral parenchymal ischemia were observed in 4 patients in the cTACE group and 5 in the DEB-TACE group.Localized bile duct dilation was seen in 2 patients in the cTACE group and 6 in the DEB-TACE group.No significant variation in serious complications between the two groups was established in localized bile duct dilatation.Other minor complications noted were liver failure,liver abscess,liver infarction,acute cholecystitis,biliary tree necrosis,and mortality.Further,no substantial variation in tumor response between the groups was reported immediately and 1-year post-procedural assessment.Conversion rate to other treatment modalities such as surgical resection,radiofrequency ablation(RFA),or swap between cTACE and DEB-TACE was substantially higher in the DEB-TACE group(40%)than in the cTACE group(10%)at the 1-year completion period of the study.Conclusion:In terms of tumor response,the DEB-TACE group showed a better response,to some extent,as an initial therapy for HCC in the early stages as compared to the cTACE group,and DEB-TACE also exhibited better clinical efficacy in patients with HCC.展开更多
文摘Hepatocellular carcinoma(HCC)is one of the most common types of malignant tumor.Although radical surgery and liver transplantation are possible cures for the disease,most patients are beyond the optimum stage for radical treatment at the time of diagnosis.Transarterial chemoembolization(TACE)is the first choice of treatment for advanced HCC.Owing to the widespread use of conventional TACE(cTACE),the problems with this treatment cannot be ignored.Drug-eluting beads(DEBs),a new type of embolization material,appear to overcome the problems of cTACE,and they have other advantages such as synchronous controlled continuous drug release after chemotherapy and embolization and low blood concentrations after treatment.This review summarizes the recent advances in the use of DEB-TACE to treat HCC.
文摘Objective:To compare the safety of conventional transarterial chemoembolization(cTACE)vs drug-eluting bead TACE(DEB-TACE)in very early-and early-stage hepatocellular carcinoma(HCC).Methods:Data of patients with early-and very early-stage HCC treated with cTACE or DEB-TACE were evaluated retrospectively in this study.A total of 40 patients were included,20 treated with cTACE and 20 with DEB-TACE.The cTACE and DEB-TACE groups were comprised of 80%and 75%males,while there were 20%females in cTACE group and 25%in Deb-TACE group respectively.The mean age of patients in cTACE group was 57.43+5.6 years,while it was 56.4+5.5 years in DEB-TACE group.All patients had liver status of Child–Pugh Class A and a score≤7 in Child-Pugh class type B in very early-(stage 0)or early-phase(stage A)stages according to the Barcelona Clinic Liver Cancer(BCLC)system.Results:The Child-Pugh class degradation in the cTACE group was slightly higher than that in the DEB-TACE group.Serious complications like peritumoral parenchymal ischemia were observed in 4 patients in the cTACE group and 5 in the DEB-TACE group.Localized bile duct dilation was seen in 2 patients in the cTACE group and 6 in the DEB-TACE group.No significant variation in serious complications between the two groups was established in localized bile duct dilatation.Other minor complications noted were liver failure,liver abscess,liver infarction,acute cholecystitis,biliary tree necrosis,and mortality.Further,no substantial variation in tumor response between the groups was reported immediately and 1-year post-procedural assessment.Conversion rate to other treatment modalities such as surgical resection,radiofrequency ablation(RFA),or swap between cTACE and DEB-TACE was substantially higher in the DEB-TACE group(40%)than in the cTACE group(10%)at the 1-year completion period of the study.Conclusion:In terms of tumor response,the DEB-TACE group showed a better response,to some extent,as an initial therapy for HCC in the early stages as compared to the cTACE group,and DEB-TACE also exhibited better clinical efficacy in patients with HCC.
