This is an observational, multicenter, single arm, prospective study to evaluate safety and tolerability of selective and ultraselective drug eluting beads transcatheter intraarterial chemoembolization (DEB-TACE) with up to 3 ml of well calibrated 100 µ microspheres and up to 150 mg of doxorubicin, for the treatment of non resectable hepatocellular carcinoma (HCC).

The hypothesis is that 100 µ beads penetrate deeper into the tumor than those eluting beads with larger volumes without increasing the risk and complications of DEB-TACE.

In this observational, prospective study patients will undergo DEB-TACE and subsequent follow up procedures according to standard clinical practice. The primary aim of the study is to describe treatment safety and tolerability of 100 µ beads in DEB-TACE. As a secondary end-point a description of efficacy parameters will be obtained.

Inclusion Criteria:

1. Patients with a diagnosis of HCC according to European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) criteria and staged by BCLC criteria
2. Indication for receiving transarterial chemoembolization DEB-TACE with 100 µ microspheres according to usual clinical practice.
3. Able and willing to participate and give their written informed consent.
4. Both genders and ≥ 18 years old.
5. Eastern Cooperative Oncology Group (ECOG) 0
6. Preserved hepatic function (Child-Pugh ≤ B7).
7. No evidence of tumoral invasion in portal vein or main biliary ducts.
8. Able to go through image diagnostic techniques such as CT or MRI.
9. Preserved cardiac and renal function.
10. No concomitant active infections that require antibiotic treatment.
11. Measurable disease according to mRECIST criteria.
12. Life expectancy over 6 months.

Exclusion Criteria:

1. ECOG ≥ 1

2. Child-Pugh ≥B8.

3. Presence of ascitis or encephalopathy

4. Extrahepatic tumoral disease.

5. Tumoral vascular invasion

6. Serum bilirubin>3 mg/dl.

7. Cr Clearance ≤ 60 ml/min

8. If any of the following is contraindicated:

   1. Administration of doxorubicin
   2. Iodated contrasts
   3. CT or MRI procedures
   4. Transarterial embolization procedures
   5. White blood cells (WBC) < 2000 /mm3
   6. Neutrophil count < 1500 /mm3
   7. Ejection fraction < 50 %
   8. Platelet count < 5 x 104/mm3, international normalized ratio (INR) > 2,0)
   9. Transaminases (AST and/or ALT) > 5x upper limit of normal or >250 u/l
   10. Known hepatofugal portal vein flow
   11. A-V intrahepatic macroscopic fistula

9. Pregnant or breast feeding women.

10. Tumor burden involving more than 50% of the liver.

11. Active bacterial or fungal infection.

12. Other concomitant tumors.

13. Any other condition that according to investigator criteria, contraindicates DEB-TACE.

14. Patients not willing to participate and/or give their written informed consent.

Target population includes:

• Patients with stage B HCC carcinoma according to Barcelona Clinic Liver Cancer classification (BCLC).
• Patients with stage A HCC according to BCLC if they are not candidates or not willing to go through surgery or radiofrecuency.

2 years

CTCAE 4.03 criteria

1. Lack of a comparative arm using larger or smaller DEBs or a cTACE group.
2. Intratumor doxorubicin doses were calculated according to the mL of injected mirospheres