Treatment efficacy and safety of drug-eluting beads transarterial chemoembolization versus conventional transarterial chemoembolization in hepatocellular carcinoma patients with arterioportal fistula

• Published in: Cancer biology & therapy 2022-12, Vol.23 (1), p.89-95
• Main Authors: Cai, Liang, Li, Honglu, Guo, Jiang, Zhao, Wenpeng, Duan, Youjia, Hou, Xiaopu, Cheng, Long, Du, Hongliu, Shao, Xihong, Diao, Zhenying, Hao, Yiwei, Zheng, Xinmei, Li, Changqing, Li, Wei
• Format: Article
• Language: English
• Subjects: arterioportal fistula; Carcinoma, Hepatocellular - pathology; Chemoembolization, Therapeutic - adverse effects; DEB-TACE; Fistula - therapy; Hepatocellular carcinoma; Humans; Liver Neoplasms - pathology; Research Paper; Retrospective Studies; safety; Treatment Outcome; treatment response
• ISSN: 1538-4047; 1555-8576
• DOI: 10.1080/15384047.2021.2020059

This study aimed to compare the treatment efficacy and tolerance between drug-eluting beads transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) in hepatocellular carcinoma (HCC) patients with arterioportal fistula (APF). A total of 44 HCC patients with APF scheduled for DEB-TACE (N = 24, as DEB-TACE group) or cTACE (N = 20, as cTACE group) were recruited. Treatment response, hepatic function, and adverse events were assessed or recorded. Besides, progression-free survival (PFS) and overall survival (OS) were calculated. Total treatment response was better in the DEB-TACE group compared with the cTACE group (P = .012). Meanwhile, the objective response rate (87.5% versus 60.0%) was higher (P = .013), while the disease control rate (95.8% versus 85.0%) was similar in the DEB-TACE group compared to the cTACE group (P = .213). Besides, PFS (mean value: 12.2 (95%CI: 9.9-14.6) months versus 7.8 (95%CI: 5.6-10.0) months) (P = .037), but not OS (mean value: 20.0 (95%CI: 18.1-21.9) months versus. 18.6 (95%CI: 15.4-21.8) months) (P = .341) was prolonged in DEB-TACE group compared with cTACE group. Regarding the safety, Child-Pugh stage, albumin level, and bilirubin level after treatment were all similar between the DEB-TACE group and cTACE group (all P > .05); moreover, no difference was found in the occurrence of adverse events during or after treatment between the two groups (all P > .05). Moreover, subsequent analyses found that embolic materials for APF (microspheres) in the DEB-TACE group did not affect the treatment efficacy (all P > .05). DEB-TACE promotes treatment response and PFS compared with cTACE and shows good safety in HCC patients with APF.