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A case of advanced intrahepatic cholangiocarcinoma successfully treated with chemosensitivity test-guided systemic chemotherapy

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World Journal of Gastroenterology 2009年第41期15卷 5228-5231页

作者： Kazumichi Abe Takeru Wakatsuki Fumiko Katsushima Kyoko Monoe Yukiko Kanno Atsushi Takahashi Junko Yokokawa Hiromasa Ohira Department of Gastroenterology and Rheumatology Fukushima Medical University School of Medicine 1 Hikarigaoka Fukushima 960-1295 Japan

Intrahepatic cholangiocarcinoma （ICC） is a relatively rare and highly fatal neoplasm that arises from the biliary epithelium. Prognosis is generally poor and survival is limited to a few months. Here we present a case of advanced ICC successfully treated by chemosensitivity test-guided systemic chemotherapy combining S-1 and cisplatin （CDDP）. A 65-year-old woman with a liver tumor was referred to our hospital on November 21, 2007. Abdominal ultrasonography and computed tomography （CT） showed low-density masses of 50 and 15 mm in diameter, respectively in segment w of the liver and in the enlarged lymph node in the para-aorta. Ultrasonography-guided fine needle biopsy diagnosed the tumors as ICC. Since the patient was inoperable for lymph node metastasis, she underwent systemic chemotherapy with gemcitabine. Six months afcer initiation of chemotherapy, CT revealed ICC progression in the liver and pleural dissemination with pleural effusion. The patient was admitted to our hospital for anticancer drug sensitivity testing on June 9, 2008. Based on the sensitivity test results, we elected to administer systemic chemotherapy combining S-1 and CDDP. Two months into the second chemotherapy treatment, CT revealed a reduction of the tumors in the liver and lymph node and a decrease in pleural *** eight cycles of the second chemotherapy, 17 mo after ICC diagnosis, she is alive and well with no sign of recurrence. We conclude that chemosensitivity testing may effectively determine the appropriate chemotherapy regimen for advanced ICC.

关键词： Chemosensitivity testing Cholangiocarcinoma, Cisplatin Liver neoplasms Gemcitabine S-1 systemic chemotherapy

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Neoadjuvant transcatheter arterial chemoembolization and systemic chemotherapy for the treatment of undifferentiated embryonal sarcoma of the liver in children

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World Journal of Clinical Cases 2022年第19期10卷 6437-6445页

作者： Min He Jia-Bin Cai Can Lai Jun-Qing Mao Jie-Ni Xiong Zhong-Hai Guan Lin-Jie Li Qiang Shu Mei-Dan Ying Jin-Hu Wang Department of Surgical Oncology The Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052Zhejiang ProvinceChina Department of Radiology The Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052Zhejiang ProvinceChina Cancer Center Zhejiang UniversityHangzhou 310058Zhejiang ProvinceChina

BACKGROUND Undifferentiated embryonal sarcoma of the liver(UESL)is a rare and aggressive mesenchymal tumor in ***,we describe our experience in neoadjuvant therapy(NAT)and subsequent surgery for the treatment of UESL in *** To evaluate the efficacy of NAT and explore a new choice for successful operation of UESL in *** We retrospectively analyzed six patients newly diagnosed with unresectable UESL who received NAT and then surgery at our center between January 2004 and December *** tumor was considered unresectable if it involved a large part of both lobes of the liver or had invaded the main hepatic vessels or inferior vena *** NAT included preoperative transcatheter arterial chemoembol ization(TACE)and systemic *** patients were 4 boys and 2 girls with a mean age of 7 *** longest tumor at presentation ranged from 8.6 to 14.8 cm(mean,12 cm).Extrahepatic metastases were present in 2 *** systemic chemotherapy was administered 3 wk after *** resection was performed 3 wk after one or two cycles of *** patients received systemic chemotherapy after *** All patients successfully underwent NAT and complete *** tumor volumes decreased by 18.2%–68.7%,with a mean decrease of 36%after 1 cycle of NAT(t=3.524,P=0.017).According to the Response Evaluation Criteria In Solid Tumors criteria,4 patients had a partial response and underwent surgery,while 2 had stable disease and received another cycle of NAT before *** tumor necrosis was seen on pathological examination of the surgical specimen:>90%necrosis in two,>50%necrosis in three,and 25%necrosis in 1,with an average of 71.8%.Post-NAT complications included fever,nausea and vomiting,and mild bone marrow *** alanine transaminase levels occurred in all patients,which returned to normal within 7–10 d after *** cardiac or renal toxicity,severe hepatic dysfunction,bleeding and nontarget e

关键词： Undifferentiated embryonal sarcoma of the liver Unresectable Neoadjuvant therapy Transcatheter arterial chemoembolization systemic chemotherapy

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Clinical and therapeutic considerations of rectal lymphoma: A case report and literature review

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World Journal of Gastroenterology 2005年第3期11卷 460-461页

作者： Yilmaz Bilsel Emre Balik Sumer Yamaner Dursun Bugra General Surgery Clinic Department of General Surgery

Primary rectal lymphoma is a rare presentation of gastrointestinal lymphomas. Its clinical presentation is indistinguishable from that of rectal carcinoma. Although surgical resection is often technically feasible, optimal therapy for colorectal lymphoma has not yet been *** report a case of primary rectal lymphoma (nonHodgkin's large cell lymphoma of type B) with high-grade features that disappeared completely after chemoradiotherapy. This case underlines that primary treatment with systemic chemotherapy and involved-field radiotherapy can be successful for rectal lymphoma, with surgery reserved for complications and chemotherapy failures.

关键词： Rectal lymphoma systemic chemotherapy Involved-field radiotherapy

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Current treatment strategies for patients with only peritoneal cytology positive stage IV gastric cancer

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World Journal of Clinical Cases 2021年第32期9卷 9711-9721页

作者： Augustinas Bausys Zilvinas Gricius Laura Aniukstyte Martynas Luksta Klaudija Bickaite Rimantas Bausys Kestutis Strupas Department of Abdominal Surgery and Oncology National Cancer InstituteVilnius 08406Lithuania Clinic of Gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 03101Lithuania Faculty of Medicine Vilnius UniversityVilnius 08406Lithuania Clinic of Gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineVilnius UniversityVilnius 03101Lithuania

Gastric cancer(GC)is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for *** a significant proportion of GC patients are found with distant metastases already at the initial *** dissemination is the most common site of *** peritoneal cytology(Cy1)is associated with poor long-term outcomes;thus,these patients are considered as stage IV even if macroscopic carcinomatosis is ***,there is no clear evidence for the most optimal treatment for this distinct subpopulation of the stage IV *** strategies vary from palliative chemotherapy to upfront *** comprehensive review summarized current evidence of different treatment strategies for Cy1 GC including roles of surgery,systemic and intraperitoneal chemotherapy.

关键词： Gastric cancer Positive peritoneal cytology Gastrectomy systemic chemotherapy Intraperitoneal chemotherapy

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Thermal ablation in colorectal liver metastases: Lack of evidence or lack of capability to prove the evidence?

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World Journal of Gastroenterology 2016年第13期22卷 3511-3515页

作者： Sergio Sartori Paola Tombesi Francesca Di Vece Section of Interventional Ultrasound St Anna Hospital

Many studies suggest that combined multimodality treatments including ablative therapies may achieve better outcomes than systemic chemotherapy alone in patients with colorectal liver metastases. Nevertheless, ablative therapies are not yet considered as effective options because their efficacy has never been proved by randomized controlled trials (RCT). However, there are in literature no trials that failed in demonstrating the effectiveness of ablative treatments: what are lacking, are the trials. All the attempts to organize phase III studies on this topic failed as a result of non accrual. Just one prospective RCT comparing radiofrequency ablation combined with systemic chemotherapy vs chemotherapy alone has been published. It was designed as a phase III study, but it was closed early because of slow accrual, and was downscaled to phase II study, with the consequent limits in drawing definite conclusions on the benefit of combined treatment. However, the combination treatment met the primary end point of the study and obtained a significantly higher 3-year progression-free survival than systemic chemotherapy alone. It is very unlikely that ultimate efficacy of ablation treatments will ever be tested again, and the best available evidence points toward a benefit for the combination strategy using ablative treatments and chemotherapy.

关键词： Liver metastases Colorectal cancer Thermal ablation Radiofrequency ablation Microwave ablation Laser ablation systemic chemotherapy

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Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?

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World Journal of Gastroenterology 2007年第32期13卷 4306-4309页

作者： Toru Ishikawa Departments of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigataJapan

Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic. Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However,the response rates have been highly variable,and are often irreproducible. To improve this low response rate,various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug,generating higher local drug concentrations in tumor cells with lower toxicity. Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and,simultaneously,a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.

关键词： Pancreatic cancer Intra-arterial chemotherapy systemic chemotherapy

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Liver metastasis of pancreatic cancer: the new choice at the crossroads

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 88-91页

作者： Zhe Liu Anjiang Gou Xingda Wu Department of Pancreatic-Biliary Surgery The First Hospital of China Medical UniversityShenyangChina

In recent years,the incidence of pancreatic cancer has increased markedly both in China and *** patients with pancreatic cancer,surgical resection remains the only effective method of obtaining a cure and long-term su... 详细信息

关键词： Pancreatic cancer with liver metastasis(PCLM) systemic chemotherapy surgery liver oligometastasis

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Target Therapy in Platinum-Refractory/Resistant Ovarian Cancer:From Preclinical Findings to Current Clinical Practice

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Journal of Cancer Therapy 2013年第5期4卷 1005-1017页

作者： Nicoletta Staropoli Cirino Botta Domenico Ciliberto Lucia Fiorillo Antonina Maria De Angelis Caterina Viscomi Simona Gualtieri Angela Salvino Pierfrancesco Tassone Pierosandro Tagliaferri Medical Oncology Unit Department of Experimental and Clinical MedicineMagna Graecia University and Tommaso Campanella Cancer CenterCampus Salvatore VenutaCatanzaroItaly

Epithelial ovarian cancer (EOC) is the sixth most common malignancy in women. Ovarian tumors consist of several clinical and pathological entities that share an anatomic site. The gold standard treatment, both in front-line and in adjuvant setting, is represented by carboplatin/paclitaxel combination. Conversely, the second-line treatment is not well defined. The response to platinum is the major prognostic factor for survival. In this review we discuss the current views on platinum-refractory/resistant patient treatment only, which includes patients progressing or relapsing within 6 months from the last platinum-based course. Concerning this subgroup, the activity of several conventional drugs was confirmed in different trials without a significant impact in terms of overall survival. In the last years particular emphasis was given to targeted anti-angiogenetic therapy which produced a survival improvement with an acceptable toxicity profile. New “ad hoc” approaches, with a major attention to outcome-predictive factors, are eagerly awaited.

关键词： Ovarian Cancer systemic chemotherapy Platinum Sensitivity Status

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Clinical study of FOLFOX4 regimen for patients of advanced hepatocellular carcinoma

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The Chinese-German Journal of Clinical Oncology 2012年第3期11卷 134-137页

作者： Hua Zhu Ping Sun Department of Oncology The Affiliated Yantai Yuhuangding Hospital of Ojngdao University Medical CollegeYantai 264000China

Objective:The aim of our study was to observe the efficiency and toxicity of oxaliplatin (L-OHP) combined with CF/5-FU in patients with advanced primary hepatocellular ***:Twenty patients with advanced primary hepatocellular carcinoma had recurrence/metastasis after multiple courses of TACE (cisplatin and epirubicin,etc.).All patients were treated with FOLFOX4 regimen of the combination of oxaliplatin and leucovorin and *** was repeated every 2 weeks until disease progression or unacceptable adverse effects *** efficiency was evaluated according to RECIST criteria,and toxicities according to American National Cancer Institute Common Toxicity Criteria (NCI CTC),***:Twenty patients were assessable for the objective efficiency and for *** patient achieved complete response (CR),4 patients were partial response (PR),8 patients were stable disease (SD),8 patients were disease progression (PD);Time to tumor progression (TTP) of the patients ranged from 1.5 to 4.8 months,median TTP was 2.2 months;Overall survival (OS) of the patients ranged from 3 to 10.2 months,median OS was 5 *** 2 patients' serum AFP level *** patients relieved the symptoms obviously,stabilized or raised up Karnofsky *** toxicities were mainly grade I-II arrest of bone marrow (50%),mild neurotoxicity (30%) and mild reaction of gastrointestinal tract (40%).Conclusion:FOLFOX4 regimen is effective and safe for patients with advanced primary hepatocellular *** can be worthy of further clinical investigation.

关键词： advanced hepatocellular carcinoma FOLFOX4 regimen systemic chemotherapy

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