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Kai-Cai Liu,1 Wei-Fu lv,2 Dong Lu,2 Chang-Long Hou,2 Jun Xie,3 Yu-He Lu,4 Qi-Sheng Cao,5 Yu-Lin Tan,6 Ying-Zhan Zhang,7 Jie Liu8 1Infection Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China; 2Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China; 3Department of Interventional Radiology, Fuyang People’s Hospital, Fuyang, People’s Republic of China; 4Department of Interventional Radiology, Chuzhou First People’s Hospital, Chuzhou, People’s Republic of China; 5Department of Interventional Radiology, Ma’anshan People’s Hospital, Ma’anshan, People’s Republic of China; 6Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 7Department of Interventional Radiology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 8Department of Interventional Radiology, Yingshang People’s Hospital, Fuyang, People’s Republic of ChinaCorrespondence: Wei-Fu lv; Dong LuDepartment of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of ChinaEmail weifulv@ustc.edu.cn; ahslludong@163.comPurpose: To investigate the potential safety and efficacy of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) in treating TACE-refractory hepatocellular carcinoma (HCC).Methods: We retrospectively evaluated the treatment outcomes of DEB-TACE for 41 HCC nodules in 30 patients who were refractory to conventional TACE (c-TACE) according to tumor response. The antitumor response was evaluated according to mRECIST criteria, and changes in alpha-fetoprotein (AFP), albumin-bilirubin score, the incidence of adverse events, and the time to disease progression were observed.Results: The objective response rate and disease control rates were 60.98% and 95.12% at 4 weeks after DEB-TACE, 63.41% and 92.68% at 8 weeks, respectively. The median time of disease progression was 4.60 ± 0.23 months. The AFP of patients decreased continuously at 2– 6 weeks after operation, and the AFP at 4 weeks was significantly lower than that at 2 weeks (P = 0.038). Adverse reactions were well tolerated, and no grade 4 adverse reactions were reported. The albumin-bilirubin score did not deteriorate within 6 weeks.Conclusion: DEB-TACE has potential efficacy and safety after failure of c-TACE in patients with advanced liver cancer. Further studies are needed to confirm the efficacy of DEB-TACE treatment after failure of c-TACE.Keywords: transcatheter arterial chemoembolization, refractory disease, drug-eluting bead, hepatocellular carcinoma, efficacy