Transarterial chemoembolization has been performed for more than 30 years with various improvements introduced since the beginning. Chemoembolization consisting of arterial injection of a mixture of Lipiodol and anticancer drugs followed by the injection of porous gelatin particles using a microcatheter in a selective manner is a mainstay in Japan. By contrast, the use of calibrated microspheres has been prevalent in recent years in chemoembolization or bland embolization of hepatocellular carcinoma worldwide. However, in 2014 the products of calibrated microspheres have been approved in Japan and chemoembolization with drug-eluting microspheres (DC-Beads
® and HapaSphere
®) became one of the choices of treatment. Drug-eluting microspheres are uniform in size and produce sustained release of drug to a tumor. At the current moment, neither chemoembolization with Lipiodol nor with drug-eluting microspheres has surpassed the other. Rather, the search for indications has been promoted in accordance with the characteristics of the respective chemoembolization. Therefore, we have to know the current status of chemoembolization with spherical microspheres. We need to rethink the role of chemotherapeutic agents in chemoembolization through the drug-eluting microspheres and improve the safety and efficacy of it.
View full abstract