• Rodolfo Sacco, Irene Bargellini, Marco Bertini, Elena Bozzi, Antonio Romano, Pasquale Petruzzi, Emanuele Tumino, Barbara Ginanni, Graziana Federici, Roberto Cioni, Salvatore Metrangolo, Michele Bertoni, Giampaolo Bresci, Giuseppe Parisi, Emanuele Altomare, Alfonso Capria, and Carlo Bartolozzi.
• Department of Gastroenterology, Pisa University Hospital, Pisa, Italy. r.sacco@ao-pisa.toscana.it
• J Vasc Interv Radiol. 2011 Nov 1; 22 (11): 1545-52.

PurposeTo compare short- and long-term clinical outcomes after conventional transarterial chemoembolization and drug-eluting bead (DEB) transarterial chemoembolization in hepatocellular carcinoma (HCC).Materials And MethodsPatients with unresectable HCC unsuitable for ablative therapies were randomly assigned to undergo conventional or DEB chemoembolization. The primary endpoints of the study were safety, toxicity, and tumor response at 1 month. Secondary endpoints were number of repeated chemoembolization cycles, time to recurrence and local recurrence, time to radiologic progression, and survival.ResultsIn total, 67 patients (mean age, 70 y ± 7.7) were evaluated. Mean follow-up was 816 days ± 361. Two periprocedural major complications occurred (2.9%) that were treated by medical therapy without the need for other interventions. A significant increase in alanine aminotransferase levels 24 hours after treatment was reported, which was significantly greater after conventional chemoembolization (n = 34) than after DEB chemoembolization (n = 33; preprocedure, 60 IU ± 44 vs 74 IU ± 62, respectively; at 24 h, 216 IU ± 201 vs 101 IU ± 89, respectively; P = 0.007). No other differences were observed in liver toxicity between groups. At 1 month, complete and partial tumor response rates were 70.6% and 29.4%, respectively, in the conventional chemoembolization group and 51.5% and 48.5%, respectively, in the DEB chemoembolization group. No differences were observed between groups in time to recurrence and local recurrence, radiologic progression, and survival.ConclusionsConventional chemoembolization and DEB chemoembolization have a limited impact on liver function on short- and long-term follow-up and are associated with favorable clinical outcomes.Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

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