• drug-eluting beads
• hepatocellular carcinoma
• meta-analysis
• systematic review
• transarterial chemoembolization

• TACE
• TAE
• TARE
• chemoembolization
• hepatocellular carcinoma
• metabolic syndrome
• nonalcoholic fatty liver disease
• nonalcoholic steatohepatitis
• radioembolization
• transarterial embolization

• bile duct invasion
• hepatocellular carcinoma
• safety
• transarterial chemoembolization
• treatment outcome

• Humans
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/mortality
• Male
• Chemoembolization, Therapeutic/methods
• Liver Neoplasms/therapy
• Liver Neoplasms/pathology
• Liver Neoplasms/mortality
• Female
• Propensity Score
• Drainage/methods
• Retrospective Studies
• Middle Aged
• Aged
• Neoplasm Invasiveness
• Treatment Outcome

• 82102161 National Natural Science Foundation of China
• 202201011719 Guangzhou Science and Technology Plan Project
• 2021A1515010548 Natural Science Foundation of Guangdong Province
• 2023A1515010481 Natural Science Foundation of Guangdong Province
• 202103000021 the Major Program for Tackling Key Problems of Guangzhou City
• National Natural Science Foundation of China
• Natural Science Foundation of Guangdong Province

• Humans
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/mortality
• Liver Neoplasms/therapy
• Liver Neoplasms/pathology
• Liver Neoplasms/mortality
• Chemoembolization, Therapeutic
• Liver Transplantation
• Retrospective Studies
• Male
• Female
• Middle Aged
• Living Donors
• Particle Size
• Treatment Outcome
• Adult
• Neoplasm Staging
• Microspheres
• Aged

• Meta-analysis
• Transarterial chemoembolization
• Tyrosine kinase inhibitors
• Unresectable hepatocellular carcinoma

• Humans
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/drug therapy
• Carcinoma, Hepatocellular/mortality
• Chemoembolization, Therapeutic/methods
• Combined Modality Therapy
• Liver Neoplasms/drug therapy
• Liver Neoplasms/therapy
• Liver Neoplasms/mortality
• Treatment Outcome
• Tyrosine Kinase Inhibitors/administration & dosage
• Tyrosine Kinase Inhibitors/adverse effects

• DEB-TACE
• beads
• chemoembolization
• hepatocellular carcinoma
• raltitrexed
• transarterial

• Humans
• Carcinoma
• Biliary Tract Neoplasms

• Hepatocellular carcinoma
• Locoregional therapy
• Systemic therapy

• Humans
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/pathology
• Liver Neoplasms/therapy
• Liver Neoplasms/pathology
• Chemoembolization, Therapeutic

• Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid
• Hepatocellular carcinoma
• Magnetic resonance imaging
• Prognostic prediction

• Humans
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/therapy
• Liver Neoplasms/blood supply
• Carcinoma, Hepatocellular/diagnostic imaging
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/pathology
• Gadolinium
• Contrast Media/pharmacology
• Gadolinium DTPA
• Magnetic Resonance Imaging/methods
• Organic Anion Transporters
• Retrospective Studies
• Tumor Microenvironment

• Drug-Eluting Bead Transarterial Chemoembolization
• Hepatocellular Carcinoma
• Radiofrequency Ablation

• Humans
• Carcinoma, Hepatocellular/pathology
• Liver Neoplasms/pathology
• Retrospective Studies
• Treatment Outcome
• Chemoembolization, Therapeutic
• Radiofrequency Ablation

• drug-eluting beads transarterial chemoembolization
• hepatocellular carcinoma
• meta-analysis

• Humans
• Carcinoma, Hepatocellular/therapy
• Chemoembolization, Therapeutic
• Liver Neoplasms/therapy
• Vascular Surgical Procedures
• Databases, Factual

• hepatocellular carcinoma
• transarterial chemoembolisation
• transarterial embolisation

• CalliSpheres® microspheres
• DEB-TACE
• cTACE
• hepatocellular carcinoma
• tumor response

• Hepatocellular carcinoma
• Multifunctional
• Nanoparticles
• Transarterial chemoembolization

• Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid
• hepatocellular carcinoma
• magnetic resonance imaging
• prognostic prediction
• transarterial chemoembolization

• Bridging
• Devascularization
• Downstaging
• Liver neoplasms
• Survival

• Contraindications
• Hepatocellular carcinoma
• Indications
• Neoadjuvant therapy
• Prognosis

Transcatheter arterial embolization (TAE) and transcatheter arterial chemoembolization (TACE) are standard treatments for advanced hepatocellular carcinoma (HCC) and particularly for unresectable tumors or liver metastases in humans. However, reports on TACE used in veterinary medicine are few. This study aimed to evaluate the feasibility and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE). We performed DEB-TACE in four clinically normal dogs and pharmacokinetically compared the results against hepatic arterial infusion (HAI) of cisplatin in two dogs. Drug-eluting beads (DEB) loaded with cisplatin were injected through a microcatheter for selective embolization of the left hepatic artery. After embolization, computed tomography (CT) images and histological examination findings were obtained during a 4-week observation period. Serum platinum concentrations were measured to evaluate cisplatin after each procedure. Biochemical analysis was performed during a 12-week observation period. Embolization was successful in all dogs, and there were no clinically apparent abnormalities. Embolization was confirmed up to 4 weeks after DEB-TACE in two of the four dogs and up to 1 week in the other two dogs using postoperative CT images. Cisplatin was not detected in peripheral veins in all dogs after DEB-TACE, but it was detected in trace amounts after HAI. DEB-TACE using cisplatin was safe and well tolerated by normal dogs. DEB-TACE may be useful in terms of determining systemic toxicity and drug concentration within tumors.

• cisplatin
• drug-eluting bead transarterial chemoembolization
• hepatocellular carcinoma

To compare the safety of conventional transarterial chemoembolization (cTACE) vs drug-eluting bead TACE (DEB-TACE) in very early- and early-stage hepatocellular carcinoma (HCC).

Data of patients with early- and very early-stage HCC treated with cTACE or DEB-TACE were evaluated retrospectively in this study. A total of 40 patients were included, 20 treated with cTACE and 20 with DEB-TACE. The cTACE and DEB-TACE groups were comprised of 80% and 75% males, while there were 20% females in cTACE group and 25% in Deb-TACE group respectively. The mean age of patients in cTACE group was 57.43 ​+ ​5.6 years, while it was 56.4 ​+ ​5.5 years in DEB-TACE group. All patients had liver status of Child–Pugh Class A and a score ≤ 7 in Child-Pugh class type B in very early- (stage 0) or early-phase (stage A) stages according to the Barcelona Clinic Liver Cancer (BCLC) system.

The Child-Pugh class degradation in the cTACE group was slightly higher than that in the DEB-TACE group. Serious complications like peritumoral parenchymal ischemia were observed in 4 patients in the cTACE group and 5 in the DEB-TACE group. Localized bile duct dilation was seen in 2 patients in the cTACE group and 6 in the DEB-TACE group.

No significant variation in serious complications between the two groups was established in localized bile duct dilatation. Other minor complications noted were liver failure, liver abscess, liver infarction, acute cholecystitis, biliary tree necrosis, and mortality. Further, no substantial variation in tumor response between the groups was reported immediately and 1-year post-procedural assessment. Conversion rate to other treatment modalities such as surgical resection, radiofrequency ablation (RFA), or swap between cTACE and DEB-TACE was substantially higher in the DEB-TACE group (40%) than in the cTACE group (10%) at the 1-year completion period of the study.

In terms of tumor response, the DEB-TACE group showed a better response, to some extent, as an initial therapy for HCC in the early stages as compared to the cTACE group, and DEB-TACE also exhibited better clinical efficacy in patients with HCC.

Transarterial chemoembolization (TACE) is a minimally invasive procedure involving intra-arterial catheter-based chemotherapy to selectively administer high doses of cytotoxic drugs to the tumor bed along with ischemic necrosis induced by arterial embolization. Chemoembolization forms the essential core of management in patients with hepatocellular carcinoma (HCC) who are not suitable for curative therapies such as transplantation, resection, or percutaneous ablation. TACE of hepatic cancer(s) has proven to be helpful in achieving local tumor control, and has supported the ability to prevent tumor progression, prolong patient life, and manage patient symptoms. Recent data have demonstrated that, in patients with single-nodule HCC ≤3 ​cm without vascular invasion, the 5-year overall survival with TACE was found to be comparable with hepatic resection and radiofrequency ablation. Used for several years, Lipiodol continues to play a vital role as a tumor-seeking and radiopaque drug delivery vector in interventional oncology. Efforts have been made to enhance the administration of chemotherapeutic agents to tumors. Compared with conventional TACE, drug-eluting bead TACE is a fairly new drug delivery embolization technique that permits fixed dosing and has the ability to provide sustained release of anticancer agents over a period of time. The present review discusses the basic procedure of TACE and its properties, and the effectiveness of conventional and drug-eluting bead chemoembolization systems currently available or presently undergoing clinical evaluation.

• Drug-eluting bead
• Hepatocellular carcinoma
• Transarterial chemoembolization

• Bland embolization
• Chemoembolization
• Hepatocellular carcinoma
• Locoregional therapy
• Radioembolization
• Thermal ablation
• Transarterial embolization

• Carcinoma, Hepatocellular/therapy
• Embolization, Therapeutic/adverse effects
• Humans
• Liver Neoplasms/therapy
• Treatment Outcome

• Hepatocellular carcinoma
• Transarterial chemoembolization
• Tumor burden score

• cone-beam computed tomography
• drug-eluting micro-spheres
• hepatocellular carcinoma
• immunotherapy
• transarterial chemoembolization

• immunotherapy
• liver neoplasms

• Adult
• Aged
• Carcinoma, Hepatocellular/drug therapy
• Carcinoma, Hepatocellular/pathology
• Chemoembolization, Therapeutic/methods
• Female
• Humans
• Immunogenic Cell Death/drug effects
• Immunotherapy/methods
• Liver Neoplasms/drug therapy
• Liver Neoplasms/pathology
• Male
• Middle Aged

• Wellcome Trust
• 26137 Cancer Research UK
• C57701/A26137 Cancer Research UK
• PS3416 Wellcome Trust
• Imperial College Healthcare NHS Trust
• Instituto de Salud Carlos III
• Imperial Experimental Cancer Medicine Centre, Cancer Research UK

Technological developments have led to an increased usage of external-body radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may be required later in patients treated with RT because of the high recurrence rate and multinodular presentation of HCC. However, despite the risk of liver function impairment, the cumulative liver damage correlated with TACE following a hepatic RT has not been adequately assessed.

To evaluate the feasibility of TACE following RT for HCC.

Sixty-seven patients with HCC who underwent TACE after RT were retrospectively evaluated between 2012 and 2018. We assessed increases in Child–Turcotte–Pugh (CTP) by ≥2 points at 1 month, the incidence of major complications, survival duration, and short-term mortality within 6 months after TACE. Furthermore, we evaluated the predictive factors for liver function impairment and short-term mortality.

Eight patients experienced a CTP increase ≥2 points at 1 month. There were no cases of liver abscesses or bilomas. Nine patients died within 6 months following TACE. The mean liver dose (MLD) was a significant predictor of liver function impairment at 1 month (p = 0.042). Low liver functional reserve, distant metastasis (p = 0.037), MLD (p = 0.046), TACE type (p = 0.025), and TACE within 3 months following RT (p = 0.007) were significant predictors of short-term mortality.

Despite the feasibility of TACE following RT, clinicians should pay attention to impaired pretreatment liver function, following high dose RT, and the short duration between RT and TACE.

• Hepatocellular carcinoma
• chemoembolization
• liver dysfunction
• radiation therapy

Drug-eluting bead transarterial chemoembolization (DEB-TACE) is the most common treatment for unresectable hepatocellular carcinoma (HCC). However, the effect of drug loading concentration and microsphere size on treatment outcomes remains unclear. This retrospective study compares the outcomes of 87 HCC patients who underwent DEB-TACE with half-loaded or full-loaded doxorubicin (maximum capacity 50 mg/mL) in 75-µm or 100-µm microspheres. Treatment with 100-μm microspheres resulted in significantly lower rates of procedure-related complications (6.6% vs. 26.9%; P < 0.05), post-embolization syndrome (32.8% vs. 61.5%, P < 0.05), SIR complications (32.8% vs. 61.5%; P < 0.01) and adverse events involving abdominal pain (19.7% vs. 42.3%; P < 0.05). Half-load doxorubicin microspheres resulted in greater treatment response (OR, 4.00; 95% CI 1.06–15.13; P, 0.041) and shorter hospital stays (OR, − 1.72; 95% CI − 2.77–0.68; P, 0.001) than did microspheres loaded to full capacity. Stratified analysis further showed that patients treated with 100-μm half-load doxorubicin microspheres had a higher CR (63.6% vs 18.0%) and ORR (90.9 vs 54.0%) and a shorter hospital stay (1.6 ± 1.3 vs 4.2 ± 2.3 days) than did those treated with full-load microspheres (P < 0.05). Thus, the drug-loading concentration of microspheres in DEB-TACE should be carefully considered.