Comparison of the efficacy and safety of conventional transarterial chemoembolization with and without drug-eluting beads embolization for the treatment of unresectable large hepatocellular carcinoma.

Background Hepatocellular carcinoma (HCC) has a poor prognosis. Moreover, large HCCs have been commonly observed. We aimed to evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) combined with conventional transarterial chemoembolization (cTACE) for the treatment of patients with unresectable large (main tumor ≥5 cm in diameter) HCC compared to cTACE alone. Methods A retrospective matched cohort study was performed on consecutive patients with unresectable large HCC who underwent TACE as the initial treatment in our institution from May 2017 and March 2019. Fifty-five patients who underwent DEB-TACE combined with cTACE were compared with a case-matched control group of 110 patients who received cTACE alone. We compared the tumor response at 1 and 3 months after TACE, time to progression (TTP), and adverse events between the groups. Results The objective response rate (ORR) was higher for the DEB-TACE combined with cTACE group than for the cTACE alone group at 1(39/55[70.9%] vs 57/110[51.8%]，P=0.019) and 3 months (27/44 [61.4%] vs 31/71 [43.7%]，P=0.048) post-treatment. The DEB-TACE combined with cTACE group also had a significantly longer median TTP than that of the cTACE group (7.2vs 5.3 months, P= 0.039). Compared to cTACE group, occurrences of abdominal pain, nausea/vomiting and constipation were significantly more frequent in the DEB-TACE combined with cTACE group (P Conclusion Compared to cTACE alone, DEB-TACE combined with cTACE significantly increased the ORR at 1 and 3 months after the treatment of unresectable large HCCs, and had a longer TTP, without any significant increase in the number of severe complications. This article is protected by copyright. All rights reserved.