Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2016; 22(40): 8853-8861
Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.8853
Transarterial chemoembolization with drug-eluting beads in hepatocellular carcinoma
Hee Chul Nam, Bohyun Jang, Myeong Jun Song
Hee Chul Nam, Bohyun Jang, Myeong Jun Song, Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul 06591, South Korea
Myeong Jun Song, Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, South Korea
Author contributions: This manuscript was written completely by the stated authors.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Myeong Jun Song, MD, PhD, Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 34943, South Korea. mjsong95@gmail.com
Telephone: +82-42-2209291
Received: July 13, 2016
Peer-review started: July 18, 2016
First decision: August 8, 2016
Revised: August 25, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: October 28, 2016

Transarterial chemoembolization (TACE) is a widely used standard treatment for patients with hepatocellular carcinoma (HCC) who are not suitable candidates for curative treatments. The rationale for TACE is that intra-arterial chemotherapy using lipiodol and chemotherapeutic agents, followed by selective vascular embolization, results in a strong cytotoxic effect as well as ischemia (conventional TACE). Recently, drug-eluting beads (DC Beads®) have been developed for transcatheter treatment of HCC to deliver higher doses of the chemotherapeutic agent and to prolong contact time with the tumor. DC Beads® can actively sequester doxorubicin hydrochloride from solution and release it in a controlled sustained fashion. Treatment with DC Beads® substantially reduced the amount of chemotherapeutic agent that reached the systemic circulation compared with conventional, lipiodol-based regimens, significantly reducing drug-related adverse events. In this article, we describe the treatment response, survival, and safety of TACE used with drug-eluting beads for the treatment of HCC and discuss future therapeutic possibilities.

Keywords: Hepatocellular carcinoma, Transarterial chemoembolization, Conventional TACE, Drug-eluting beads, Treatment response

Core tip: Drug eluting beads are relatively new embolic agents that allow sustained release of chemotherapeutic agents in a localized fashion to the tumor. The advantage of DC bead transarterial chemoembolization (TACE) is a better combined ischemic and cytotoxic effect locally and less system toxicity when compared with conventional TACE.