Single- versus Triple-Drug Chemoembolization for Hepatocellular Carcinoma: Comparing Outcomes by Toxicity, Imaging Response, and Survival

Samdeep K. Mouli, Ryan Hickey, Bartley Thornburg, Kent T. Sato, Kush Desai, Ahmed Gabr, Joseph R. Kallini, Halla Niemeri, Sheetal Kircher, Mary F. Mulcahy, Al B. Benson, Ramona Gupta, Riad Salem, Robert J. Lewandowski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose To determine the efficacy of single- versus triple-drug chemoembolization for the treatment of hepatocellular carcinoma, as measured by toxicity, tumor response, time to progression (TTP), and overall survival (OS). Materials and Methods A single-center retrospective review was performed on 337 patients who underwent chemoembolization over a 14-year period; 172 patients underwent triple-drug conventional transarterial chemoembolization, and 165 patients underwent single-agent doxorubicin chemoembolization. Imaging characteristics and clinical follow-up after conventional transarterial chemoembolization were evaluated to determine TTP. Imaging response was determined per World Health Organization and European Association for the Study of Liver criteria. OS from time of first chemoembolization was calculated. Results Median TTP was similar between groups: 7.9 months (95% confidence interval [CI], 7.1–9.4) and 6.8 months (95% CI, 4.6–8.6) for triple- and single-drug regimens, respectively (P > .05). For single-agent conventional transarterial chemoembolization, median OS varied significantly by Barcelona Clinic for Liver Cancer (BCLC) stage: A, 40.8 months; B, 36.4 months; C, 10.9 months (P < .01). Median OS for triple-drug therapy also varied significantly by BCLC: A, 28.9 months; B, 18.1 months; C, 9.0 months (P < .01). Single-drug conventional transarterial chemoembolization demonstrated longer median OS compared with triple-drug therapy (P < .05) for BCLC A/B patients. Conclusions Single-agent chemoembolization with doxorubicin and ethiodized oil demonstrates acceptable efficacy as measured by TTP and OS. Results compare favorably with traditional triple-drug therapy.

Original languageEnglish (US)
Pages (from-to)1279-1287
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Issue number9
StatePublished - Sep 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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