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Published: . Dec 2014

Prajapati HJ, Xing M, Spivey JR, Hanish SI, El-Rayes BF, Kauh JS, Chen Z, Kim HS

Survival, efficacy, and safety of small versus large doxorubicin drug-eluting beads TACE chemoembolization in patients with unresectable HCC.
(AJR Am J Roentgenol)

The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100-300 ┬Ám) versus large (300-500 and 500-700 ┬Ám) doxorubicin drug-eluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC). Ninety-four consecutive patients with unresectable HCC who underwent 269 DEB TACE procedures in 48 months were studied. DEB TACE procedures were performed using different DEB sizes: 100-300 ┬Ám (Group A, 59 patients) and with mixed 300-500 and 500-700 ┬Ám DEB (Group B, 35 patients). Survival rates were compared between the groups. The overall median survival in groups A and B were 15.1 and 11.1 months, respectively (p=0.005). Both groups were similar in demographics, tumor burden, and differential staging (p>0.5). Substratification of overall survival according to Child-Pugh class and Okuda, Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC) staging were significantly higher in group A than in group B (p<0.05). Common terminology criteria for adverse events (CTCAE) grade III adverse events and 30-day mortality were significantly lower in group A than in group B (6.8% vs 20%; p=0.04, and 0% vs 14.3%; p=0.001, respectively). The particle size, Child-Pugh class, and serum ╬▒-fetoprotein level were significant prognostic indicators of survival on multivariate analysis. TACE with 100-300 ┬Ám sized DEB is associated with significantly higher survival rate and lower complications than TACE with 300-500 and 500-700 ┬Ám sized DEB.

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Read more articles from the authors:
1. Prajapati HJ
2. Xing M
3. Spivey JR
4. Hanish SI
5. El-Rayes BF
6. Kauh JS
7. Chen Z
8. Kim HS

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