Drug-eluting beads transarterial chemoembolization improves tumor response and survival compared with conventional...

Transarterial chemoembolization (TACE) is standard treatment for intermediate-stage hepatocellular carcinoma (HCC), but the optimal embolization technique remains debated. This study aimed to compare effects of drug-eluting beads TACE (DEB-TACE) and conventional TACE (cTACE) on liver function and long-term survival in these patients. This retrospective investigation examined a cohort of 255 individuals diagnosed with intermediate-stage HCC, all of whom received TACE treatments at First Affiliated Hospital of Dalian Medical University between January 2019 and December 2022. Participants were categorized into cTACE group (n = 110) and DEB-TACE group (n = 145). Liver function parameters were measured at baseline, 1 week, and 1 month post-treatment. Tumor response was assessed at 1 month using mRECIST criteria. Tumor recurrence was evaluated at 3 and 6 months. Overall survival (OS) and progression-free survival (PFS) were analyzed, and adverse events were recorded. The DEB-TACE group required fewer treatment sessions (P = 0.003) and received a higher chemotherapy dose (P = 0.038). At 1 week post-treatment, DEB-TACE patients showed higher total bilirubin (TBIL, P = 0.004) and lower albumin (ALB, P = 0.012), but these differences resolved by 1 month. DEB-TACE achieved superior objective response rate (ORR, P = 0.008) and disease control rate (DCR, P = 0.019), with lower 6-month recurrence rates (P = 0.010). PFS and OS were significantly longer with DEB-TACE (P < 0.001). Multivariate analysis verified that DEB-TACE serves as an independent protective element for both PFS and OS (P < 0.001). Adverse event rates were similar between groups. DEB-TACE shows enhanced effectiveness compared to cTACE regarding tumor response, recurrence control, and long-term survival for intermediate-stage HCC, with comparable safety and only transient differences in early post-procedural liver function.