Initial drug-eluting beads transarterial chemoembolization using hepaspheres in patients with large (≥5 cm)
Dong Il Gwon1, Jin Hyoung Kim1, Hee Ho Chu1
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, the Republic of Korea.
Purpose:
To investigate clinical outcomes of initial drug-eluting beads transarterial chemoembolization (DEB-TACE) using HepaSpheres in patients with large (≥5 cm) hepatocellular carcinoma (HCC).
Methods:
This study included treatment naïve patients who underwent DEB-TACE using HepaSpheres 20-40 µm and/or 30-60 µm as first-line or bridge treatment for large HCC between April 2017 and December 2023.
Results:
This study enrolled 180 patients (155 men, 25 women; mean age, 63.9 years; range, 35-90 years) with large HCC (mean diameter, 9.1 cm; range, 5-19.5 cm). Among them, 57.2% (n = 103) experienced post-embolization syndrome after DEB-TACE, and 43.3% (n = 78) experienced major adverse events. The complete and partial responses, and progressive disease rates after initial DEB-TACE were 12.2%, 86.7%, and 1.1%, respectively, leading to a highly fevorable response rate of 98.9%. Forty-two (23.3%) patients underwent subsequent resection after DEB-TACE. The median patient survival time was 26.2 months and the cumulative survival times at 1, 2, 3, and 5 years were 74%, 52%, 40%, and 25%, respectively. Multivariate Cox regression analyses showed that tumor size (HR, 0.674 for tumor < 10 cm; p = 0.036), number (HR, 0.660 for single HCC; p = 0.038), type (HR, 0.623 for nodular type; p = 0.037), and subsequent surgical resection (HR, 0.177 for subsequent surgical resection; p < 0.001) were significantly associated with the post-DEB-TACE overall survival rate.
Conclusion:
The results of this study suggest that initial DEB-TACE using HepaSpheres is an effective treatment approach in patients with large HCC ≥ 5 cm.
