abstract:the aim of this study was to explore the difference of liver function change, safety profiles and efficacy of drug-eluting bead transarterial chemoembolization(deb-tace) therapy between elderly and middle-aged hepatocellular carcinoma(hcc) patients. 91 hcc patients were enrolled in this prospective cohort study.they were treated by deb-tace therapy and divided into elderly group (age >=65 years, n=30) and middle-aged group (age < 65 years, n=61), liver function, safety profiles and treatment response were recorded. no difference of liver function was found between two groups before operation and at 1 week post deb-tace treatment. while the portion of abnormal total protein (tp) in elderly group was elevated than that in middle age group at 1-3 months after operation. during operation, elderly group presented with raised incidence of vomiting compared with middle-aged group, whereas elderly patients displayed lower incidence of pain than middle-aged patients at 1 month post treatment. no other difference of safety profiles was found between the two groups. at 1-3 months after treatment, elderly patients achieved complete response (cr) of 26.7% and overall response rate (orr) of 93.3%, meanwhile, middle-aged patients obtained cr of 23.0% and orr of 90.2%. no difference of cr and orr was found between elderly and middle-aged patients, in addition, no difference of os was observed between the two groups. in conclusion, deb-tace therapy was well tolerated in elderly hcc patients, and it possessed equal efficacy in elderly patients compared with middle-aged patients.