All patients included were treated with TACE, including conventional TACE (cTACE) and drug-eluting bead TACE (DEB-TACE). Interventional physicians choose cTACE or DEB-TACE based on tumor burden and patient characteristics. The basic treatment process of DEB-TACE resembles that of cTACE except for the embolic agents. cTACE uses lipiodol (Guerbet), gelatin sponge particles, and polyvinyl alcohol as embolic agents. Selective or super-selective embolization of tumor-supplying vessels is performed whenever technically justified [23 (link)]. For DEB-TACE, 100–300 μm diameter CalliSpheres® Beads (CB; Jiangsu Hengrui Pharmaceutical Co., Ltd.) were used as carriers, loaded with 60–80 mg epirubicin, pirarubicin, or doxorubicin. All procedures were administered by interventional physicians with at least 10 years of experience. All patients were admitted for postoperative supportive care after TACE procedure and were managed routinely.
Study cohort judgment of TACE response was performed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) [24 (link)] criterion. In brief, the therapeutic response of TACE was stratified into four grades: (a) complete response (CR): complete disappearance of the lesion; (b) partial response (PR): a minimum 30% reduction in the sum of diameters of viable target lesions (enhancement in the arterial phase); (c) progressive disease (PD): at least 20% extension in the sum of the diameters of viable (enhancing) target lesions; and (d) stable disease (SD): neither PR nor PD. Based on mRECIST, CR and PR patients were categorized as objective response (OR) cohort, and PD and SD patients as non-objective response (NOR) group. This assessment was determined by two professional abdominal radiologists based upon the follow-up MR images. Among the 144 patients enrolled, 75 were assigned to the NOR group and 69 to the OR group. In the independent external validation set, 14 patients were in the NOR group and 14 in the OR group.
Study cohort judgment of TACE response was performed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) [24 (link)] criterion. In brief, the therapeutic response of TACE was stratified into four grades: (a) complete response (CR): complete disappearance of the lesion; (b) partial response (PR): a minimum 30% reduction in the sum of diameters of viable target lesions (enhancement in the arterial phase); (c) progressive disease (PD): at least 20% extension in the sum of the diameters of viable (enhancing) target lesions; and (d) stable disease (SD): neither PR nor PD. Based on mRECIST, CR and PR patients were categorized as objective response (OR) cohort, and PD and SD patients as non-objective response (NOR) group. This assessment was determined by two professional abdominal radiologists based upon the follow-up MR images. Among the 144 patients enrolled, 75 were assigned to the NOR group and 69 to the OR group. In the independent external validation set, 14 patients were in the NOR group and 14 in the OR group.
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