Safety and efficacy analysis of DEB-TACE treatment in elderly patients with hepatocellular carcinoma: a comparative cohort study

: The aim of this study was to explore the difference of liver function change, safety profiles and efficacy of drug-eluting bead transarterial chemoembolization (DEBTACE) therapy between elderly and middle-aged hepatocellular carcinoma (HCC) patients. 91 HCC patients were enrolled in this prospective cohort study. They were treated by DEB-TACE therapy and divided into elderly group (age >= 65 years, n=30) and middle-aged group (age < 65 years, n=61), liver function, safety profiles and treatment response were recorded. No difference of liver function was found between two groups before operation and at 1 week post DEB-TACE treatment. While the portion of abnormal total protein (TP) in elderly group was elevated than that in middleage group at 1-3 months after operation. During operation, elderly group presented with raised incidence of vomiting compared with middle-aged group, whereas elderly patients displayed lower incidence of pain than middle-aged patients at 1 month post treatment. No other difference of safety profiles was found between the two groups. At 1-3 months after treatment, elderly patients achieved complete response (CR) of 26.7% and overall response rate (ORR) of 93.3%, meanwhile, middle-aged patients obtained CR of 23.0% and ORR of 90.2%. No difference of CR and ORR was found between elderly and middle-aged patients, in addition, no difference of OS was observed between the two groups. In conclusion, DEB-TACE therapy was well tolerated in elderly HCC patients, and it possessed equal efficacy in elderly patients compared with middle-aged patients.