Analysis of the Safety and Short-Term Efficacy of Lipiodol Combined with Drug-Eluting Microspheres for Transarterial Chemoembolization in the Treatment of Hepatocellular Carcinoma

Abstract

Objective: To compare the short-term efficacy and safety of lipiodol combined with drug-eluting beads transarterial chemoembolization (LD-TACE) with conventional transarterial chemoembolization (c-TACE) in patients with hepatocellular carcinoma (HCC). Methods: The clinical data of 113 patients with HCC treated by transarterial chemoembolization (TACE) in two medical centers from January 2017 to June 2021 were retrospectively analyzed. Among them, 54 cases received LD-TACE, and 59 cases received c-TACE. For patients in the LD-TACE group, moderate lipiodol embolization was conducted first, followed by embolization with drug-eluting microspheres. For the patients in the c-TACE group, lipiodol was administered via chemotherapy drug emulsion embolization first;Then, gelatin sponge particles were used to strengthen the embolization. The objective response rate (ORR), disease control rate (DCR), serum alpha-fetoprotein (AFP), and postoperative adverse events (AEs) were analyzed and compared between the two groups of patients after the first TACE. Results: At 6–8 weeks after the first TACE, the ORR of the LD-TACE and the c-TACE groups were 68.5% and 47.5%, respectively (p = 0.024), and the DCR of the groups were 94.4% and 88.1%, respectively (p = 0.238). The reduction rate in the serum AFP was 87% and 74.6%, respectively (p = 0.095). In terms of AEs, nausea and vomiting were experienced by 46 patients in the c-TACE group;However, they occurred in only 24 patients in the LD-TACE group (p < 0.001). In addition, 33 patients in the c-TACE group had elevated bilirubin (BIL) after surgery, while elevated BIL occurred in only 17 cases in the LD-TACE group (p = 0.007). There were no significant differences in the incidence of postoperative abdominal pain, fever, or elevated transaminase between the two groups (p > 0.05 in all). Conclusions: Compared with the patients who received c-TACE, the patients who received LD-TACE had higher short-term ORRs and fewer postoperative gastrointestinal AEs in the treatment of selective unresectable HCC.