## 4 Rationale for Each TACE Technique
### Technical Advantages of Selective cTACE Compared with Non-Selective cTACE  
Non-selective cTACE using a large volume of iodized oil is not only less effective for tumors but also more harmful for normal liver parenchyma; therefore, catheter position is very important to reduce the total dose of iodized oil and minimize the liver damage. cTACE also damages the hepatic artery by arteritis due to chemotherapeutics and allergic reaction to gelatin [66,67], and attenuation of the hepatic arterial circulation reduces the hepatic function and causes the extrahepatic collaterals to develop [68,69]. Therefore, damage to the hepatic artery by cTACE should be minimized so as to preserve the liver function and prolong the duration of TACE treatment. Generally, selective cTACE is defined as cTACE at the segmental hepatic artery, whereas superselective cTACE is defined as cTACE at the subsegmental hepatic artery. cTACE at the most distal level of the subsubsegmental hepatic artery is termed ultraselective cTACE [13,40]. \begin{table}
\begin{tabular}{c c c c c c c c c c c} \hline \hline \multirow{2}{*}{**Author** **(Year)**} & \multirow{2}{*}{**Group/** **Subgroup**} & \multirow{2}{*}{**TACE**} & **Bead** & **CR** & **FR** & **OR** & \multirow{2}{*}{**P-Value**} & \multirow{2}{*}{**OS (\%)**} & \multirow{2}{*}{**P-Value**} \\  & & & **Size** & **(\(\mu\)m)** & & & & & & **1 y** & **2 y** \\ \hline \multirow{3}{*}{[PERSON] Ref. [62] (2010)} & \multirow{3}{*}{Advanced disease*} & DEB & 93 & 26.9 & 24.7 & 51.6 & \multirow{3}{*}{0.11} & \multirow{3}{*}{} & \multirow{3}{*}{} \\  & cTACE & 108 & mainly, & 22.2 & 21.3 & 43.5 & & & & \\  & DEB & 63 & 300–500 & & 52.4 & & & & & \\  & cTACE & 72 & & & & & & & & \\ \hline \multirow{3}{*}{[PERSON] Ref. [63] (2011)} & DEB & 33 & \multirow{3}{*}{100-300} & 51.5 & 48.5 & 100 & \multirow{3}{*}{0.1} & 90 & 87 & 0.96 \\  & cTACE & 34 & & 70.6 & 29.4 & 100 & & & & 90 & 84 \\ \hline \multirow{3}{*}{[PERSON] Ref. [64] (2014)} & DEB & 89 & \multirow{3}{*}{100-300} & 52.2 & 7.5 & 59.7 & \multirow{3}{*}{0.217} & 86 & 57 & 0.949 \\  & cTACE & 88 & & & & & & & & 84 & 55 & \\ \hline \multirow{3}{*}{Ikeda Ref. [65] (2020)} & DEB & 99 & \multirow{3}{*}{100-300} & 35.7 & at 1 month & \multirow{3}{*}{} & \multirow{3}{*}{} & \multirow{3}{*}{} \\  & cTACE & & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \hline \multirow{3}{*}{Sacco Ref. [63] (2011)} & DEB & 33 & \multirow{3}{*}{100-300} & 51.5 & 48.5 & 100 & \multirow{3}{*}{} & \multirow{3}{*}{} \\  & cTACE & 34 & & & & & & & & \\ \cline{1-1}  & cTACE & 34 & & & & & & & & \\ \hline \multirow{3}{*}{Golleiri Ref. [64] (2014)} & DEB & 89 & \multirow{3}{*}{100-300} & 52.2 & 7.5 & 59.7 & \multirow{3}{*}{0.217} & 86 & 57 & 0.949 \\  & cTACE & 88 & & & & & & & & 84 & 55 & \\ \hline \multirow{3}{*}{Ikeda Ref. [65] (2020)} & DEB & 99 & \multirow{3}{*}{100-300} & 35.7 & at 1 month & \multirow{3}{*}{} & \multirow{3}{*}{} & \multirow{3}{*}{} & \multirow{3}{*}{} \\  & cTACE & & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \hline \multirow{3}{*}{Ikeda Ref. [65] (2020)} & DEB & 99 & \multirow{3}{*}{100-300} & 52.6 & at 3 months & \multirow{3}{*}{} & \multirow{3}{*}{} & \multirow{3}{*}{} \\  & cTACE & 101 & & & & & & & & \\ \cline{1-1}  & & & & & & & & & & \\ \hline \multirow{3}{*}{\({}^{\star}\) At least, one of Child-Pugh B, ECOG 1, recurrent disease, bilobar disease was present. Abbreviations: CR, complete response; PR, partial response; OR, objective response; OS, overall survival.} & & & & & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Comparison of therapeutic effects between DEB-TACE and cTACE. Most microsatellite lesions, which are usually non-selective cTACE-resistant [15], are located in the corona enhancement area [70]. The corona area should be included in the treatment area because cancer cells first enter there before forming distant metastatic lesions.