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Atezolizumab plus bevacizumab and tremelimumab plus durvalumab: how should we choose these two immunotherapy regimens for advanced hepatocellular carcinoma?

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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 927-930页

作者： takeshi hatanaka Atsushi Naganuma Yutaka Yata Satoru Kakizaki Department of Gastroenterology Gunma Saiseikai Maebashi HospitalMaebashiJapan Department of Gastroenterology National Hospital Organization Takasaki General Medical CenterTakasakiJapan Department of Gastroenterology Hanwa Memorial HospitalOsakaJapan Department of Clinical Research National Hospital Organization Takasaki General Medical CenterTakasakiJapan

We read with interest the manuscript(1)by Bruix et al.regarding a European Association for the Study of the Liver(EASL)position paper on the systemic treatment of hepatocellular carcinoma(HCC).Systemic treatment optio... 详细信息

关键词： hepatocellular regimen

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Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

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World Journal of Hepatology 2018年第7期10卷 485-495页

作者： takeshi hatanaka Hirotaka Arai Satoru Kakizaki Department of Gastroenterology Saiseikai Maebashi Hospital Department of Gastroenterology Maebashi Red Cross Hospital Department of Gastroenterology and Hepatology Gunma University Graduate School of Medicine

Transcatheter arterial chemoembolization(TACE) is widely accepted as a treatment for patients with hepatocellular carcinoma(HCC) in the intermediate stage according to the Barcelona Clinic Liver Cancer(BCLC) guidelines. Recently, balloon-occluded TACE(B-TACE) was developed in Japan. Despite the lack of a clear definition, B-TACE is generally defined as the infusion of emulsion of chemotherapeutic agents with lipiodol followed by gelatin particles under the occlusion of feeding arteries by a microballoon catheter, which leads to the dense lipiodol emulsion(LE) accumulation in HCC nodules. This phenomenon cannot be explained only by the prevention of proximal migration and leakage of embolization materials; it further involves causing local changes in the hemodynamics of the surrounding occlusion artery and targeted HCC nodules. Balloon-occluded arterial stump pressure plays an important role in the dense LE accumulation in targeted HCC nodules. Although randomized controlled trials comparing the therapeutic effect and the prognosis of B-TACE to those of the other TACE procedures, such as conventional-TACE and drug-eluting beads TACE, are still lacking, B-TACE is thought to be a promising treatment. The purpose of this review is to summarize the mechanism, therapeutic effect, indication, prognosis and complications of BTACE.

关键词： Hepatocellular carcinoma Treatment effect Transcatheter arterial chemoembolization Prognosis Balloon-occluded arterial stump pressure Dense lipiodol emulsion accumulation Balloon-occluded transcatheter arterial chemoembolization Microballoon catheter

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Efficacy of 5-Fluorouracil and High-Concentration Cisplatin Suspended in Lipiodol by Short-Term Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

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Journal of Cancer Therapy 2015年第13期6卷 1151-1161页

作者： Yutaka Yata Masashi Namikawa Tatsuya Ohyama Takashi Ohsaki Daisuke Kanda takeshi hatanaka Kei Shibuya Jun Kubota Hitoshi Takagi Terumi Takahara Teruo Yoshinaga Department of Gastroenterology Saiseikai Maebashi Hospital Maebashi-City Japan Department of Radiology Saiseikai Maebashi Hospital Maebashi-City Japan Third Department of Internal Medicine Toyama University Toyama-City Japan

Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.

关键词： Advanced Hepatocellular Carcinoma (HCC) Portal Vein Tumor Thrombosis (PVTT) Hepatic Arterial Infusion Chemotherapy (HAIC) 5-FU a Fine-Powder Formulation of Cisplatin Quality of Life (QOL) Cost-Effective Treatment

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