The effect of interval time of transcatheter arterial chemoembolization with drug-eluting beads on the efficacy and safety of unresectable hepatocellular carcinoma: a case-control study.

Purpose: To investigate the effect of treatment interval on the efficacy and safety of transcatheter arterial chemoembolization with drug-eluting beads (DEB-TACE) in patients with unresectable hepatocellular carcinoma (HCC). Methods: Retrospective analysis of clinical data of HCC patients admitted to our hospital from December 2015 to December 2023. Kaplan Meier method was used to calculate survival rate, survival curve was plotted, log rank test was used for univariate analysis, and Cox regression model was used to analyze independent prognostic factors. Select cutoff values based on OS using X-tile software for grouping, and compare the impact of time intervals on OS and adverse reactions. Results: The median OS of the entire group was 26 months, and the 1-, 3-, and 5-year survival rates were 85.6%, 48.3%, and 41.8%, respectively. Multi factor analysis shows that, BCLC, The occurrence of splenomegaly, targeted therapy, and TACE interval are independent prognostic factors for overall survival. The analysis of treatment interval grouping showed that the cut-off value of TACE time interval was 4 weeks. The group with TACE interval>4 weeks (long interval group) showed better survival benefits than the group with TACE interval<4 weeks (short interval group) (mOS: 47 vs 34 months, P<0.001). The sub group analysis results showed that in the sub group analysis of ECOG grade 0 patients, no distant metastasis, and Child Pugh A patients, the long interval group had longer OS than the short interval group. One week after the second postoperative follow-up and comparison of laboratory indicators between the two groups, the differences in lactate dehydrogenase (LDH) and platelets between the two groups were significant (P<0.05). No serious treatment-related complications were observed in any of the patients. Conclusion: DEB-TACE performed at intervals longer than 4 weeks has a better prognosis for HCC than DEB-TACE performed within 4 weeks without increasing adverse reactions.