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World J Hepatol. Jun 28, 2017; 9(18): 808-814
Published online Jun 28, 2017. doi: 10.4254/wjh.v9.i18.808
Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma
Jeong Eun Song, Do Young Kim
Jeong Eun Song, Do Young Kim, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea
Author contributions: Kim DY provided the concept; Song JE and Kim DY wrote the manuscript.
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: Do Young Kim, MD, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. dyk1025@yuhs.ac
Telephone: +82-2-22281992 Fax: +82-2-3936884
Received: January 27, 2017
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
Abstract

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.

Keywords: Hepatocellular carcinoma; Drug-eluting beads transarterial chemoembolization; Transarterial chemoembolization

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.