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Is hepatic arterial infusion chemotherapy effective treatment for advanced hepatocellular carcinoma resistant to transarterial chemoembolization?

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World Journal of Gastroenterology 2012年第16期18卷 1933-1939页

作者： hiroyuki kirikoshi Masato Yoneda Hironori Mawatari Koji Fujita Kento Imajo Shingo Kato Kaori Suzuki Noritoshi Kobayashi Kensuke Kubota Shin Maeda Atsushi Nakajima Satoru Saito Gastroenterology Division Yokohama City University Graduate School of Medicine3-9 Fuku-uraKanazawakuYokohama 236-0004Japan

AIM:To evaluate the effectiveness of hepatic arterial infusion chemotherapy(HAIC) for advanced hepatocellular carcinoma(HCC) resistant to transarterial chemoembolization(TACE).METHODS:This study was conducted on 42 patients who received HAIC for advanced HCC between 2001and 2010 at our hospital.5-fluorouracil(5-FU) was administered continuously for 24 h from day 1 to day 5 every 2-4 wk via an injection reservoir.Intra-arterial cisplatin or subcutaneous interferon was administered in combination with the 5-FU.The patients enrolled in this retrospective study were divided into two groups according to whether or not they fulfilled the criteria for resistance to TACE proposed by the Japan Society of Hepatology in 2010(written in Japanese);one group of patients who did not fulfill the criteria for TACE resistance(group A,n = 23),and another group who fulfilled the criteria for TACE resistance(group B,n = 19).We compared the outcomes in terms of the response and survival rates between the two groups.RESULTS:Both the response rate and tumor suppression rate following HAIC were significantly superior in group A than in group B(response rate:48% vs 16%,P = 0.028,tumor suppression rate:87% vs 53%,P = 0.014).Furthermore,both the progression-free survival rate and survival time were significantly superior in group A than in group B(3-,6-,12-,and 24-mo = 83%,70%,29% and 20% vs 63%,42%,16% and 0%,respectively,P = 0.040,and 9.8 mo vs 6.2 mo,P = 0.040).A multivariate analysis(Cox proportional hazards regression model) showed that resistance to TACE was an independent predictor of poor survival(P = 0.007).CONCLUSION:HAIC administrating 5-FU was not effective against advanced HCC resistant to TACE.Other tools for treatment,i.e.,molecular-targeting agents may be considered for these cases.

关键词：肝动脉化学栓塞化疗肝癌晚期治疗灌注

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Levovist ultrasonography imaging in intracystic hemorrhage of simple liver cyst

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World Journal of Gastroenterology 2008年第5期14卷 805-807页

作者： Tomoyuki Akiyama Masahiko Inamori Satoru Saito Hirokazu Takahashi Masato Yoneda Koji Fujita Toshio Fujisawa Yasunobu Abe hiroyuki kirikoshi Kensuke Kubota Michio Ueda Kuniya Tanaka Shinji Togo Norio Ueno Hiroshi Shimada Atsushi Nakajima Division of Gastroenterology Yokohama city University Hospital Yokohama 236-0004 Japan Division of Surgery Yokohama city University Hospital Yokohama 236-0004 Japan

The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Ultrasonography (US) demonstrated a heterogeneous echogenic cyst measuring 11 cm × 8 cm in size in S2 of the liver, indicated intracystic hemorrhage of simple liver cyst or cystadenocarcinoma, but the differential diagnosis was considerably difficult. Levovist (Schering, Berlin, Germany) US revealed no enhancement of the intracystic structures, suggesting a clot in the case of intracystic hemorrhage. An operation was performed and the resected lesion showed a solitary benign liver cyst, measuring 5.5 cm × 4.7 cm × 8.5 cm containing a large blood clot. The patient had an uneventful recovery after the surgery. Levovist US may play an important role in discrimination between intracystic hemorrhage of simple hepatic cysts and cystadenocarcinoma of the liver.

关键词：肝囊肿囊腺癌半乳糖氧化酶症状

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