Treatment response, survival and safety profile of transarterial chemoembolization using different sizes of drug-eluting beads in hepatocellular carcinoma patients with portal vein tumor thrombus.

Abstract Background Different sized microspheres may affect the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT), but related data are lacking. Therefore, the current study aimed to investigate the treatment response, survival and safety of DEB-TACE using different sized microspheres in HCC patients with or without PVTT. Methods Totally 90 HCC patients underwent DEB-TACE treatment were retrospectively enrolled (30 cases with PVTT and 60 cases without PVTT). According to the sizes of microspheres, patients were divided into 100-300μm, 300-500μm and 500-700μm groups, respectively. Results Disease control rate (DCR) was highest in 300-500μm group (81.3%), followed by 500-700μm group (50.0%), then the lowest in 100-300μm group (12.5%) (P=0.004); while objective response rate (ORR) was similar among three groups (P=0.177) in patients with PVTT. Furthermore, overall survival (OS) (P=0.513) and adverse events (all P>0.05) were similar among three groups in patients with PVTT. Besides, in patients without PVTT: ORR (P=0.694), DCR (P=0.591), OS (P=0.816) were of no difference among three groups; but the fever incidence was highest in 300-500μm group (65.0%), second high in 500-700μm group (50.0%), then lowest in 100-300μm group (25.0%) (P=0.008), except for this, no difference of other adverse events among three groups was found (all P>0.05). Conclusion DEB-TACE using 300-500μm microspheres (versus 100-300μm or 500-700μm microspheres) exhibits best treatment response without additional adverse events, indicating it might be the optimal choice for HCC patients with PVTT.