Trans-arterial chemoembolization with doxorubicin-eluting particles versus conventional trans-arterial chemoembolization in unresectable hepatocellular carcinoma: A study of effectiveness, safety and costs

Abstract

ObjectivesTo compare the effectiveness, survival and cost in patients with unresectable hepatic cell carcinoma (HCC) treated with trans-arterial chemoembolization using doxorubicin-eluting beads (DEB-TACE) versus conventional TACE (cTACE) in clinical practice. Materials and methodsThis single-centered retrospective observational study compared 60 consecutive HCC unresectable patients: 30 were treated with DEB-TACE and 30 used cTACE. Comparisons were with χ2 test, Student t-test, and Kaplan–Meier method. ResultsOf the 60 patients with HCC in non-curative stage, baseline characteristics were similar for both groups of treatment, and of these we observed lower survival in male patients and those who had hepatitis C virus (p=0.014 and p=0.003, respectively). No statistically significant differences were observed as a function of treatment employed with respect to overall survival (OS) at 5 years (29.99 months; 95%CI: 21.38–38.60 versus 30.67 months; 95%CI: 22.65–38.70; p=0.626) and progression free survival (PFS) median of 11.57 months (95%CI: 0.97–22.18) versus 12.80 months (95%CI: 0.00–32.37; p=0.618). The median length of hospital admission was 2.6 and 5.4 days (p<0.001) for DEB-TACE and cTACE, respectively. Toxicities grade 2–4 were higher in cTACE group (54 versus 31; p<0.001). The cost of the treatment was 1581 € for DEB-TACE and 514.63 € for cTACE. The overall mean cost of intervention was 3134 € and 3694.35 €, respectively (p=0.173). ConclusionsChemoembolization in patients with unresectable HCC achieved OS close to 30 months at 5 years, independent of the technique employed. Similar overall costs but better tolerance of the DEB-TACE justified the higher costs of the procedure.