Balloon-Occluded Transarterial Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma

Area of Science:

• Hepatobiliary oncology
• Interventional radiology
• Cancer therapy

Background:

• Transarterial chemoembolization (TACE) is standard for intermediate-stage hepatocellular carcinoma (HCC).
• Conventional TACE (cTACE) and drug-eluting bead TACE (DEB-TACE) have high recurrence rates.
• Balloon-occluded TACE (B-TACE) may improve outcomes by enhancing intratumoral drug deposition.

Purpose of the Study:

• To evaluate the short-term outcomes of B-TACE for HCC.
• To assess the efficacy and safety of B-TACE in unresectable HCC.
• To identify predictors of treatment response for B-TACE.

Main Methods:

• Retrospective single-center study of 50 patients with unresectable HCC treated with B-TACE.
• Tumor response assessed using LI-RADS Treatment Response (LR-TR) and mRECIST criteria.
• Progression-free survival (PFS) analyzed; lipiodol deposition classified as a surrogate marker for drug distribution.

Main Results:

• Overall response rate was 72.0% (54.0% complete response).
• Patients with BCLC stages A and B had higher response rates (77.3%) than stage C (33.3%).
• Type I lipiodol deposition correlated strongly with complete response and superior PFS; predictors included lipiodol pattern, lesion number, and baseline AFP.

Conclusions:

• B-TACE demonstrates high efficacy and acceptable safety for HCC treatment.
• Lipiodol deposition pattern is a key predictor of treatment outcomes.
• B-TACE is a promising alternative to cTACE/DEB-TACE for intermediate-stage HCC.