Purpose: To evaluate the short-term clinical efficacy, side effects, and risk factors affecting the clinical effectiveness of CalliSpheres drug-loaded bead-transcatheter arterial chemoembolization (DEB-TACE) in the treatment of primary hepatocellular carcinoma (HCC).
Material and Methods: A total of 172 consecutive patients with HCC undergoing DEB-TACE (loaded with doxorubicin) from August 2016 to July 2018 were prospectively enrolled. Short-term local tumor response was evaluated by the modified RECIST criteria. Postoperative complications and liver function disorders were analyzed based on examinations and clinical symptoms.
Results: The median follow-up period was 310 days. Based on the mRECIST criteria, objective response rates (CR+PR) were 78.7%, 71.6% and 63.2%, and disease control rates (CR+PR+SD) were 95.3%, 92.1% and 85.9% at 2, 4 and 6 months post-treatment, respectively. Multivariate logistic regression analysis showed that nodule number >3, high BCLC stage, vascular leak, and previous cTACE treatment were associated with poor ORR (P<0.05). Post-operation, liver function showed transient changes. Postoperative complications were tolerated and relieved by symptomatic treatment. The average interval of TACE before D-TACE was 43 days, compared with 70 days for average interval of DEB-TACE. The average hospital stay was 1.87 days.
Conclusions: DEB-TACE has improved short-term efficacy and lower incidence of complications in primary HCC and prolongs the interval of TACE. It significantly increases the ORR, especially in patients with no extra-hepatic metastasis pre-treatment. DEB usage actually improves treatment efficacy and provides more benefits to patients.