Intra-arterial chemoembolization with hepasphere 50–100 μm for patients with unresectable hepatocellular carcinoma: Initial experience in Egyptian Liver Hospital

ObjectiveThis study examined the efficacy of transarterial chemoembolization of unresectable hepatocellular carcinoma using hepasphere 50–100 μm.MethodsA total number of 52 patients with radiologically documented HCC [Child–Pugh score A and B; 32 and 20 respectively] were embolized with hepasphere 50–100 μm. Forty-six patients were HCV positive and 6 patients were HBV positive. Local response of the tumor was evaluated radiologically after 1, 3, 6, 9 months and one year.ResultsTACE with hepasphere 50–100 μm was tolerated by all patients with no major complications. The total number of lesions in 52 patients was 67 lesions. Complete response was seen in 40 patients (76.9%), while residual lesions seen in 12 patients (23.1%). As regards complications, 48 patients (92.4%) developed post-embolization syndrome, 2 patients (3.8%) had isolated partial IVC thrombosis while 2 patients (3.8%) showed combined partial IVC thrombosis and partial thrombosis of posterior branch of right portal vein.ConclusionHepasphere 50–100 μm is efficient for the treatment of hypervascular HCC. Further advances in drug-eluting beads including their size tailored to tumor anatomy may improve the results. Large series of patients, follow up for longer periods and comparison with conventional TACE and TACE with other DEB are needed.