Comparative outcomes of DEB-TACE and conventional TACE in Hepatocellular Carcinoma: Current evidence and future perspectives

Elsaman, Ahmed; Othman, Moustafa Hashem Mahmoud; Ali Mourad, Mohammad Zaki; Abdelghany, Hisham

doi:10.21608/smj.2025.413827.1610

Comparative outcomes of DEB-TACE and conventional TACE in Hepatocellular Carcinoma: Current evidence and future perspectives

Document Type : Review Article

Authors

¹ Faculty of medicine, Sohag university

² Department of diagnostic and interventional radiology, Faculty of Medicine, Assiut University

³ Department of Diagnostic Radiology, Faculty of Medicine, Sohag University

⁴ department of Radiology, Faculty of Medicine, Sohag university

10.21608/smj.2025.413827.1610

Abstract

One of the three main cancer types linked to mortality, hepatocellular carcinoma (HCC) is the sixth most widespread form of cancer and frequently arises in individuals with underlying liver cirrhosis. Given that 3–5% of cirrhotic patients develop HCC annually, routine monitoring through ultrasound is essential. The staging system for Barcelona Clinic Liver Cancer (BCLC) is frequently used to help choose the best course of treatment. Definitive treatments like liver resection or Patients with early-stage illness are typically candidates for transplantation., while transarterial chemoembolization (TACE) is commonly employed as the primary therapy for individuals with intermediate-stage HCC. TACE includes three main approaches: Drug-eluting bead TACE (DEB-TACE), conventional TACE (c-TACE), and degradable starch microsphere TACE (DSM-TACE). c-TACE employs a chemotherapeutic mixture based on lipiodol, which is followed by embolization. DEB-TACE enables more controlled drug release and limits systemic toxicity, while DSM-TACE provides temporary embolization and remains under investigation. Technique selection depends on tumor burden, liver function, and treatment intent. Comparative studies between c-TACE and DEB-TACE have yielded mixed results. Some randomized trials and meta-analyses report no significant differences in survival or tumor response, though DEB-TACE may offer safety advantages in patients with portal vein thrombosis or compromised liver function. Early clinical trials in China showed that DEB-TACE had favorable pharmacokinetics, low toxicity, and promising tumor responses. Common complications, including post-embolization syndrome, were reported at similar rates across both methods. While neither method has shown consistent superiority, DEB-TACE may provide slight clinical benefits in select subgroups.

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