@article{3110988, title = "Transcatheter treatment of hepatocellular carcinoma with doxorubicin-loaded dc bead (DEBDOX): Technical recommendations", author = "Lencioni, R. and De Baere, T. and Burrel, M. and Caridi, J.G. and Lammer, J. and Malagari, K. and Martin, R.C.G. and O'Grady, E. and Real, M.I. and Vogl, T.J. and Watkinson, A. and Geschwind, J.-F.H.", journal = "CardioVascular and Interventional Radiology", year = "2012", volume = "35", number = "5", pages = "980-985", issn = "0174-1551, 1432-086X", doi = "10.1007/s00270-011-0287-7", keywords = "debdox; doxorubicin; iodinated poppyseed oil; microsphere; nonionic contrast medium; unclassified drug, artery catheter; chemoembolization; computer assisted tomography; drug delivery system; drug eluting bead; drug megadose; hepatic artery; human; liver cell carcinoma; loading drug dose; nuclear magnetic resonance imaging; particle size; priority journal; review; treatment failure; treatment planning; treatment response; tumor volume, Antibiotics, Antineoplastic; Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Doxorubicin; Drug Carriers; Drug Implants; Humans; Liver Neoplasms", abstract = "Tranarterial chemoembolization (TACE) has been established by a meta-analysis of randomized controlled trials as the standard of care for nonsurgical patients with large or multinodular noninvasive hepatocellular carcinoma (HCC) isolated to the liver and with preserved liver function. Although conventional TACE with administration of an anticancer-in-oil emulsion followed by embolic agents has been the most popular technique, the introduction of embolic drug-eluting beads has provided an alternative to lipiodol-based regimens. Experimental studies have shown that TACE with drug-eluting beads has a safe pharmacokinetic profile and results in effective tumor killing in animal models. Early clinical experiences have confirmed that drug-eluting beads provide a combined ischemic and cytotoxic effect locally with low systemic toxic exposure. Recently, the clinical value of a TACE protocol performed by using the embolic microsphere DC Bead loaded with doxorubicin (DEBDOX; drug-eluting bead doxorubicin) has been shown by randomized controlled trials. An important limitation of conventional TACE has been the inconsistency in the technique and the treatment schedules. This limitation has hampered the acceptance of TACE as a standard oncology treatment. Doxorubicin-loaded DC Bead provides levels of consistency and repeatability not available with conventional TACE and offers the opportunity to implement a standardized approach to HCC treatment. With this in mind, a panel of physicians took part in a consensus meeting held during the European Conference on Interventional Oncology in Florence, Italy, to develop a set of technical recommendations for the use of DEBDOX in HCC treatment. The conclusions of the expert panel are summarized. © 2011 The Author(s)." }