Published online Feb 7, 2023. doi: 10.3748/wjg.v29.i5.890
Peer-review started: October 24, 2022
First decision: December 12, 2022
Revised: December 17, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 7, 2023
Processing time: 105 Days and 5.4 Hours
Transarterial chemoembolization (TACE) is the current standard treatment for intermediate-stage hepatocellular carcinoma (HCC). Post-embolization syndrome (PES) is a complex clinical syndrome which may occur after conventional TACE (cTACE). Either N-acetylcysteine (NAC) or dexamethasone (DEXA) is used to prevent PES.
The synergistic effect of the combined therapy for preventing PES and liver decompensation has not been determined.
The aim of this study was to evaluate the efficacy of NAC and DEXA combination in preventing PES and liver decompensation after cTACE.
A single-center randomized controlled clinical trial.
Our study provides clinical evidence that intravenous NAC plus DEXA administration ameliorates the occurrence of post-TACE PES in patients with intermediate-stage HCC. Interestingly, we found that a dynamic change in Albumin-Bilirubin (ALBI) score was a risk factor for post-TACE liver decompensation.
A combination of NAC and DEXA ameliorated the occurrence of PES after cTACE in patients with intermediate-stage HCC.
The application of dynamic increase in ALBI score for a prediction of early post-TACE liver decompensation requires further research.