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Balloon-occluded chemoembolization for hepatocellular carcinoma: a prospective study of safety, feasibility and outcomes

Gontran Verset et al. Hepatic Oncology(2020)

5/21/2021 -  


Currently, only two recent retrospective studies have evaluated B-TACE using DEMs (B-DEM-TACE) in HCC and showed positive results in terms of safety and efficacy. We report here the first prospective study assessing the feasibility and safety of B-TACE using PEG embolizing microspheres loaded with 75 mg doxorubicin (B-DEM-TACE) in a selected population of HCC patients.


Evaluation of safety and efficacy of selective balloon-occluded transarterial chemoembolization using polyethylene glycol embolizing microspheres in patients with hepatocellular carcinoma.


  • 24 patients with 40 HCC lesions underwent B-DEM-TACE

  • Adverse events were evaluated at 24 h and 1 month

  • Imaging response according to modified response evaluation criteria in solid tumours was assessed at 1, 3 and 6 months


Gontran Verset et al registry demonstrated:


  • Nine patients (37.5%) received a second treatment and two of them (22.2%) went on to a third treatment without worsening of the liver function.

  • All 24 patients were candidates for multimodal treatment after B-DEM-TACE due to the lack of hepatic injury. 


  • The 1-month follow-up imaging post-treatment by contrast-enhanced MRI was available for 39 nodules and showed an overall response per nodule of 74.3% (48.7% CR and 25.6% PR) and a best overall response of 70.9% (41.7% CR and 29.2% PR)


Gontran Verset et al concluded that B-DEM-TACE has proven to be an effective treatment for HCC patients with a very good safety profile. In our series we have observed fewer AEs than previously described with other catheters, suggesting an added value of this technique in terms of liver function preservation. If future trials will confirm these observations, B-DEM-TACE may become a valuable tool for intra-arterial LRTs mostly for frail patients.

Key Takeaway:

The main findings of Gontran Verset et al are that:

  • This technique enables to improve the selectivity of TACE, which is an added value for the treatment of HCC particularly in cirrhotic patients, who are most likely to present an impaired liver function.

  • Currently, a key point of locoregional therapy is the preservation of liver function, ever since the development of various systemic therapies that improve OS of these patients.

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