Efficacy and safety of drug-eluting bead-transcatheter arterial chemoembolization using 100–300 μm versus 300–500 μm CalliSpheres microspheres in patients with advanced-stage hepatocellular carcinoma

To evaluate the efficacy and safety of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) using 100-300 μm versus 300-500 μm CalliSpheres microspheres (CSMs) for treating multiple hepatocellular carcinoma (HCC) with the largest nodule measuring between 5 and 10 cm.Eighty-one advanced-stage HCC patients treated by DEB-TACE between January 2017 and March 2020 were retrospectively analyzed. There were 48 patients in the 100-300 μm group and 33 patients in the 300-500 μm group. Treatment response, liver function tests, and complications were compared between the two groups.At 6 months, the response rates in the 100-300 μm group were higher than those in the 300-500 μm group (P < 0.05). Disease control rates in the 100-300 μm group were higher than those in the 300-500 μm group at 1, 3, and 6 months (P < 0.05). Progression-free survival (PFS) and overall survival (OS) were longer in the 100-300 μm group (P < 0.05). Visual analog score points were higher in the 300-500 μm group (P < 0.05). There were no significant differences in complications between the two groups.The use of small-diameter CSMs in multiple HCC with the largest nodule size of 5-10 cm provides better treatment response and longer PFS and OS for treating advanced-stage HCC.