***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To compare short- and long-term clinical outcomes after conventional transarterial chemoembolization and drug-eluting bead ( DEB ) transarterial chemoembolization in hepatocellular carcinoma ( HCC ) . MATERIAL S AND METHODS Patients with unresectable HCC unsuitable for ablative therapies were r and omly assigned to undergo conventional or DEB chemoembolization . The primary endpoints of the study were safety , toxicity , and tumor response at 1 month . Secondary endpoints were number of repeated chemoembolization cycles , time to recurrence and local recurrence , time to radiologic progression , and survival . RESULTS In total , 67 patients ( mean age , 70 y ± 7.7 ) were evaluated . Mean follow-up was 816 days ± 361 . Two periprocedural major complications occurred ( 2.9 % ) that were treated by medical therapy without the need for other interventions . A significant increase in alanine aminotransferase levels 24 hours after treatment was reported , which was significantly greater after conventional chemoembolization ( n = 34 ) than after DEB chemoembolization ( n = 33 ; preprocedure , 60 IU ± 44 vs 74 IU ± 62 , respectively ; at 24 h , 216 IU ± 201 vs 101 IU ± 89 , respectively ; P = 0.007 ) . No other differences were observed in liver toxicity between groups . At 1 month , complete and partial tumor response rates were 70.6 % and 29.4 % , respectively , in the conventional chemoembolization group and 51.5 % and 48.5 % , respectively , in the DEB chemoembolization group . No differences were observed between groups in time to recurrence and local recurrence , radiologic progression , and survival . CONCLUSIONS Conventional chemoembolization and DEB chemoembolization have a limited impact on liver function on short- and long-term follow-up and are associated with favorable clinical outcomes Transcatheter arterial chemoembolization ( TACE ) offers a survival benefit to patients with intermediate hepatocellular carcinoma ( HCC ) . A widely accepted TACE regimen includes administration of doxorubicin-oil emulsion followed by gelatine sponge — conventional TACE . Recently , a drug-eluting bead ( DC Bead ® ) has been developed to enhance tumor drug delivery and reduce systemic availability . This r and omized trial compares conventional TACE ( cTACE ) with TACE with DC Bead for the treatment of cirrhotic patients with HCC . Two hundred twelve patients with Child-Pugh A/B cirrhosis and large and /or multinodular , unresectable , N0 , M0 HCCs were r and omized to receive TACE with DC Bead loaded with doxorubicin or cTACE with doxorubicin . R and omization was stratified according to Child-Pugh status ( A/B ) , performance status ( ECOG 0/1 ) , bilobar disease ( yes/no ) , and prior curative treatment ( yes/no ) . The primary endpoint was tumor response ( EASL ) at 6 months following independent , blinded review of MRI studies . The drug-eluting bead group showed higher rates of complete response , objective response , and disease control compared with the cTACE group ( 27 % vs. 22 % , 52 % vs. 44 % , and 63 % vs. 52 % , respectively ) . The hypothesis of superiority was not met ( one-sided P = 0.11 ) . However , patients with Child-Pugh B , ECOG 1 , bilobar disease , and recurrent disease showed a significant increase in objective response ( P = 0.038 ) compared to cTACE . DC Bead was associated with improved tolerability , with a significant reduction in serious liver toxicity ( P < 0.001 ) and a significantly lower rate of doxorubicin-related side effects ( P = 0.0001 ) . TACE with DC Bead and doxorubicin is safe and effective in the treatment of HCC and offers a benefit to patients with more advanced disease Background To compare the overall survival of patients with hepatocellular carcinoma ( HCC ) who were treated with lipiodol-based conventional transarterial chemoembolization ( cTACE )  with that of patients treated with drug-eluting bead transarterial chemoembolization ( DEB-TACE ) .  Methods By an electronic search of our radiology information system , we identified 674 patients that received TACE between November 2002 and July 2013 . A total of 520 patients received cTACE , and 154 received DEB-TACE .  In total , 424 patients were excluded for the following reasons : tumor type other than HCC ( n = 91 ) , liver transplantation after TACE ( n = 119 ) , lack of histological grading ( n = 58 ) , incomplete laboratory values ( n = 15 ) , other reasons ( e.g. , previous systemic chemotherapy ) ( n = 114 ) , or were lost to follow-up ( n = 27 ) . Therefore , 250 patients were finally included for comparative analysis ( n = 174 cTACE ; n = 76 DEB-TACE ) . Results There were no significant differences between the two groups regarding sex , overall status ( Barcelona Clinic Liver Cancer classification ) , liver function ( Child-Pugh ) , portal invasion , tumor load , or tumor grading ( all p > 0.05 ) . The mean number of treatment sessions was 4 ± 3.1 in the cTACE group versus 2.9 ± 1.8 in the DEB-TACE group ( p = 0.01 ) . Median survival was 409 days ( 95 % CI : 321–488 days ) in the cTACE group , compared with 369 days ( 95 % CI : 310–589 days ) in the DEB-TACE group ( p = 0.76 ) . In the subgroup of Child A patients , the survival was 602 days ( 484–792 days ) for cTACE versus 627 days ( 364–788 days ) for DEB-TACE ( p = 0.39 ) . In Child B/C patients , the survival was considerably lower : 223 days ( 165–315 days ) for cTACE versus 226 days ( 114–335 days ) for DEB-TACE ( p = 0.53 ) . Conclusion The present study showed no significant difference in overall survival  between cTACE and DEB-TACE in patients with HCC . However , the significantly lower number of treatments needed in the DEB-TACE group makes it a more appealing treatment option than cTACE for appropriately selected patients with unresectable HCC Background : Transcatheter arterial chemoembolization ( TACE ) is the st and ard treatment in selected patients with unresectable hepatocellular carcinoma ( HCC ) . Drug-eluting particles are developed to reduce side effects and improve efficacy . We present safety data of a prospect i ve r and omized phase II study with doxorubicin-eluting superabsorbent polymer ( SAP ) microspheres . Material and Methods : We prospect ively included 30 HCC patients with different Barcelona Clinic Liver Cancer ( BCLC ) stages ( A = 3 , B = 19 , C = 8) and r and omly assigned them to receive conventional TACE ( n = 14 ) ( control group ) or doxorubicin-eluting SAP microspheres ( n = 16 ) . The  doxorubicin plasma level was assessed at different time points , biochemical analysis was performed , and side effects were reported following the Common Toxicity Criteria . Tumor response was assessed at 6 weeks according to the modified Response Evaluation Criteria in Solid Tumors ( RECIST ) criteria . Results : There was a significantly lower plasma peak concentration ( Cmax ) of doxorubicin and smaller area under the curve ( AUC ) with SAP microspheres ( mean Cmax 495 ± 293.9 ng/ml , mean AUC 69.7 ± 26.9 ng/ml min ) compared to controls ( mean Cmax 1,928 ± 560.8 ng/ml , mean AUC 165 ± 32.3 ng/ml/min ; both p < 0.001 ) . Furthermore , there were less grade 3 and no grade 4 adverse events in the SAP microsphere group . Tumor response was comparable between the groups . Conclusions : TACE with SAP microspheres leads to low plasma levels of the cytotoxic drug and therefore minimizes toxicity compared to conventional TACE Background : Transcatheter arterial chemoembolisation ( TACE ) is the treatment of choice for intermediate stage hepatocellular carcinoma ( HCC ) .  Doxorubicin-loaded drug-eluting beads (DEB)-TACE is expected to improve the performance of conventional TACE ( cTACE ) . The aim of this study was to compare DEB-TACE with cTACE in terms of time-to-tumour progression ( TTP ) , adverse events ( AEs ) , and 2-year survival . Methods : Patients were r and omised one-to-one to undergo cTACE or DEB-TACE and followed-up for at least 2 years or until death . Transcatheter arterial chemoembolisation was repeated ‘ on-dem and ’ . Results : We enrolled 177 patients : 89 underwent DEB-TACE  and 88 cTACE . The median number of procedures was 2 in each arm , and the in-hospital stay was 3 and 4 days , respectively ( P=0.323 ) . No differences were found in local and overall tumour response . The median TTP was 9 months in both arms . The AE incidence and severity did not differ between the arms , except for post-procedural pain , more frequent and severe after cTACE ( P<0.001 ) . The 1- and 2-year survival rates were 86.2 % and 56.8 % after DEB-TACE and 83.5 % and 55.4 % after cTACE ( P=0.949 ) . Eastern Cooperative Oncology Group ( ECOG ) , serum albumin , and tumour number independently predicted survival ( P<0.05 ) . Conclusions : The DEB-TACE and the cTACE are equally effective and safe , with the only advantage of DEB-TACE being less post-procedural abdominal pain Objective Lipiodol transcatheter arterial chemoembolization ( TACE ) is widely used to treat hepatocellular carcinoma ( HCC ) . Recently , a drug-eluting bead ( DEB ) has been developed to enhance drug delivery to the tumor and reduce its systemic availability . The purpose of this study was to compare the efficacy and safety of intra-arterial injection of DEB loaded with doxorubicin versus conventional , Lipiodol-based TACE regimens in Asian patients with HCC . Methods The study was design ed as a case – control , single-institution clinical trial . Twenty patients with HCC who received DEB loaded with 50 mg doxorubicin ( ‘ cases ’ ) were matched with 20 patients who had undergone conventional TACE ( ‘ controls ’ ) . The primary efficacy endpoint was tumor response at 1 month according to modified Response Evaluation Criteria in Solid Tumors . The primary safety endpoint was liver toxicity . Results The rate of objective response by modified Response Evaluation Criteria in Solid Tumors was 85 % ( 17 of 20 patients ) in the DEB arm versus 30 % ( six of 20 patients ) in the conventional TACE arm ( P=0.001 ) . Subgroup analyses conducted in patients with large ( > 5 cm ) or multinodular tumor confirmed significantly higher objective response rates in patients receiving DEB as compared with those treated with conventional TACE ( P=0.003 and P=0.005 , respectively ) . At the dose of 50 mg doxorubicin , there was no statistically significant difference in liver toxicity between DEB and conventional TACE ( P>0.05 ) . Conclusion In Asian patients with HCC , transcatheter treatment with DEB loaded with doxorubicin offers a distinct advantage in objective tumor response rate as compared with conventional , Lipiodol-based TACE regimens Chemoembolization with lipiodol ( TACE ) improves survival of selected patients with unresectable hepatocellular carcinoma ( HCC ) , but results in substantial toxicity . To improve treatment tolerance , we conducted this phase II study using doxorubicin-loaded beads ( DC Beads ® ) delivered by selective transcatheter arterial chemoembolization ( DEB-TACE ) . We compared the results with those obtained with TACE in our historical controls . Thirty-five patients were recruited with diagnoses of HCC . Patients received DEB-TACE with doxorubicin loaded on DC Beads . Computed tomography of the upper abdomen was performed one month after DEB-TACE . Historical controls were a group of 70 patients with matched characteristics treated with TACE . After a median follow-up of 14.1 months ( range , 6 - 36 months ) , 22 patients ( 63 % ) had an objective response . There was a statistically significant decrease in liver enzymes ( p<0.001 ) , lactate dehydrogenase , ( p<0.001 ) in DEB-TACE-treated patients compared to TACE-treated patients . DEB-TACE with doxorubicin-loaded DC Beads , a safe and reliable treatment for HCC , leads to decreased toxicity compared to TACE 
    Output:
    
CONCLUSION Compared with cTACE , DEB-TACE therapy significantly improved 1- , 2- , and 3-year OS rates and the 1- and 2-year RFS rates