Introduction: The aim of this multicenter comparison of balloon-occluded transarterial chemoembolization (B-TACE) versus conventional TACE (cTACE) in treating hepatocellular carcinoma (HCC) was to assess in which size range the 2 techniques offered higher complete response (CR) and objective response (OR) rates in a single session, and to evaluate the possibility of using B-TACE to reduce the need for re-treatment. Methods: 325 patients were retrospectively evaluated: 91 patients in the B-TACE group (22 with cTACE [B-cTACE] and 69 with drug-eluting microsphere TACE [B-DEM-TACE]) and 234 in the cTACE group. The results were compared according to tumor size: (A) #x3c;30 mm, (B) 30–50 mm, and (C) #x3e;50 mm; OR and CR rates after the first session and the number of TACE re-interventions within a 6-month period were also evaluated using propensity score matching (PSM). Results: The best target ORs were very high (93.2%) and similar between the 2 treatments both before (94.4% for cTACE and 90.1% for B-TACE) and after PSM (94.5% for cTACE and 90.1%; p = 0.405), with slightly better results for the cTACE cohort probably due to better cTACE effectiveness in smaller lesions. In lesions #x3c;30 mm, cTACE obtained a slightly higher CR rate than B-TACE (61.9 vs. 56.3%, p = 0.680), whereas in intermediate-sized HCCs (30–50 mm), B-TACE showed a significant superiority in achieving a CR (72.3 vs. 54.1%, respectively; p = 0.047). In larger lesions (#x3e;50 mm), cTACE and B-TACE performed equally, with a poor CR rate (22.6 vs. 23.1%, respectively; p = 1.000). These results were additionally confirmed using PSM. The patients treated with B-TACE had a significantly lower re-treatment rate than the cTACE cohort (12.1 vs. 26.9%, respectively; p = 0.005). B-cTACE and B-DEM-TACE demonstrated similar ORs, with a slightly better CR rate for B-cTACE (68.2 vs. 56.5%, respectively; p = 0.456). Conclusion: In HCCs of 30–50 mm, B-TACE should be preferred to cTACE, whereas in smaller nodules (#x3c;30 mm), cTACE can suffice in achieving a good CR rate. The statistically significant lower re-treatment rate of the B-TACE cohort after a single procedure reduced the risk of complications due to multiple TACE, which could worsen the patient prognosis.
Liver Cancer

中文翻译：

---

球囊闭塞经动脉化疗栓塞：在哪个尺寸范围内表现最佳？使用倾向评分匹配比较其与传统经动脉化疗栓塞的疗效

简介：这项多中心比较球囊闭塞经动脉化疗栓塞 (B-TACE) 与传统 TACE (cTACE) 治疗肝细胞癌 (HCC) 的目的是评估这两种技术在哪个大小范围内提供更高的完全缓解 (CR) 和单次治疗的客观缓解 (OR) 率，并评估使用 B-TACE 减少再治疗需求的可能性。方法：对 325 名患者进行了回顾性评估：B-TACE 组 91 名患者（22 名 cTACE [B-cTACE] 和 69 名药物洗脱微球 TACE [B-DEM-TACE]）和 cTACE 组 234 名。根据肿瘤大小比较结果：(A) #x3c;30 mm, (B) 30-50 mm, 和 (C) #x3e;50 mm; 第一次治疗后的 OR 和 CR 率以及 6 个月内 TACE 再次干预的次数也使用倾向评分匹配 (PSM) 进行了评估。结果：最佳目标 OR 非常高 (93.2%)，并且在 2 种治疗之前（cTACE 为 94.4%，B-TACE 为 90.1%）和 PSM 之后（cTACE 为 94.5% 和 90.1%；p= 0.405），cTACE 队列的结果稍好，可能是由于 cTACE 在较小病变中的效果更好。在病灶#x3c;30 mm 中，cTACE 的 CR 率略高于 B-TACE（61.9 对 56.3%，p = 0.680），而在中等大小的 HCC（30-50 mm）中，B-TACE 显示出显着的CR 率在实现 CR 方面的优势（分别为 72.3 和 54.1%；p = 0.047）。在较大的病灶（#x3e；50 mm）中，cTACE 和 B-TACE 的表现相同，但 CR 率较差（分别为 22.6% 和 23.1%；p = 1.000）。这些结果还使用 PSM 得到了证实。接受 B-TACE 治疗的患者的再治疗率明显低于 cTACE 队列（分别为 12.1% 和 26.9%；p= 0.005)。B-cTACE 和 B-DEM-TACE 表现出相似的 OR，B-cTACE 的 CR 率略高（分别为 68.2 和 56.5%；p = 0.456）。结论：在 30-50 mm 的 HCC 中，B-TACE 应优于 cTACE，而在较小的结节 (#x3c;30 mm) 中，cTACE 足以实现良好的 CR 率。单次手术后 B-TACE 队列的再治疗率在统计学上显着降低，这降低了因多次 TACE 引起的并发症风险，这可能使患者预后恶化。
肝癌