Efficacy and Safety of Supplemental Transarterial Chemoembolization Through Extrahepatic Collateral Arteries with Drug eluting Beads: Treatment for Unresectable Hepatocellular Carcinoma
Purpose To evaluate the therapeutic efficacy and safety of supplement transarterial chemoembolization (TACE) with drug eluting beads TACE (DEB TACE) through extrahepatic collateral (EHC) arteries for the treatment of hepatocellular carcinoma (HCC) Patients and Methods In this retrospective study, 61 unresectable HCC patients with treatment naive EHC blood supplies who received TACE from January 2016 to March 2019 were enrolled; of these patients, 42 (68.9% received DEB TACE, and 19 (31.1% received cTACE. The hepatic tumor feeding arteries were treated in the same TACE session if it presented. The tumor response, time to progression (TTP) and overall survival (OS) were analyzed. Safety was assessed based on the occurrence of liver function deterioration and major complications within three months after TACE. Results DEB TACE showed better efficacy than cTACE in the disease control rate (p=0.001) overall response rate (p=0.005) the TTP (eight months vsthree months, p=0.002) and the OS (23.8 months vs nine months, p=0.045) Nine patients in the DEB TACE group and one patient in the cTACE group were downstaged to resection or liver transplantation (21.4% vs 5.3% p=0.151) DEB TACE and cTACE have no difference in the acute and chronic liver toxicity. With regard to complications, there was no significant difference in the occurrence of both major (16.7% vs 21.1% p=0.72) and minor (57.1% vs 47.4% p=0.48) complications between DEB TACE and cTACE. Conclusion DEB TACE through EHC arteries has a potential therapeutic effect in the treatment of unresectable HCC, with comparable safety compared with cTACE.
Drug design, development and therapy