Transarterial chemoembolization of hepatocelluler carcinoma with small doxorubicin-eluting beads

Purpose: The purpose of this study is to evaluate the short-term safety and efficacy of the new generation doxorubicin loaded drug-eluting beads which are sized below 100μm. Materials and Methods: From March 2013 to April 2014, 20 patients with HCC underwent TACE with 40 and 75µm drug-eluting beads (Embozene TANDEM Microspheres; CeloNova BioSciences, Inc, San Antonio, Texas) loaded with doxorubicin. The abdominal aortography, selective celiac and SMA angiographies were performed and drug-eluting bead embolization was done as selective and superselectively. All patients underwent MRG before the treatment and at the 1st day, 1 month and 3 months after treatment. Local response was evaluated with modified response evaluation criteria in solid tumors (mRECIST). Results: At the 1st month after TACE, overall complete response (CR), partial response (PR), stable disease (SH), progressive disease (PH) and overall objective response (OR) respectively were 50 %, 15 %, 10 %, 25 %, 65 % and 50 %, 11 %, 17 %, 22 % , 61% at the 3rd month. The presence of non-target lesions cause increasing levels of CR and decreasing levels of PH. CR for target lesions ≤ 5cm was 100% at first day, 1 month and 3 months after treatment. In our study AST and ALT values was increased within 24 hours after treatment reaching noncritical levels, although there was a significantly decline in 1-2 months in most patients. Conclusion: In conclusion, the present pilot study shows that there is no difference in short term response between 40-75μm microspheres and the large sizes doxorubicin-eluting beads which were reported in the literature, according to mRECIST. However, Overall complete response (CR) rate was higher for target lesions ≤5 cm than larger lesions.