Published online Jun 28, 2017. doi: 10.4254/wjh.v9.i18.808
Peer-review started: February 12, 2017
First decision: March 9, 2017
Revised: May 10, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: June 28, 2017
Processing time: 144 Days and 1.2 Hours
Transarterial chemoembolization (TACE) is the current standard of therapy for patients with intermediate-stage hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer classification. The concept of conventional TACE (cTACE) is the selective obstruction of tumor-feeding artery by injection of chemotherapeutic agents, leading to ischemic necrosis of the target tumor via cytotoxic and ischemic effects. Drug-eluting beads (DEBs) have been imposed as novel drug-delivering agents for TACE, which allows for higher concentrations of drugs within the target tumor and lower systemic concentrations compared with cTACE. Despite the theoretical advantages of DEB-TACE, it is still controversial in clinical practice as to whether DEB-TACE is superior to cTACE in regard to overall survival and treatment response. In this review article, we summarize the clinical efficacy and safety of DEB-TACE for patients with intermediate or advanced stage HCC in comparison with cTACE.
Core tip: Transarterial chemoembolization (TACE) is the current standard of therapy for patients with intermediate-stage hepatocellular carcinoma. Drug-eluting beads (DEBs) have been introduced as novel drug-delivery agents for TACE, allowing for higher concentrations of drugs to the target tumor and lower systemic concentrations, compared with conventional TACE (cTACE). Despite the theoretical advantages of DEB-TACE, whether DEB-TACE shows superior efficacy to cTACE remains controversial. Reviewing the literature, we found that DEB-TACE shows similar clinical outcomes to and fewer adverse events than cTACE.