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Clinical efficacy of Gamma Knife® combined with transarterial chemoembolization and immunotherapy in the treatment of primary liver cancer

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1601-1608页

作者： Guo-Feng Wang Chang-Xin Shu Xiao-Dong Cai Hong-Bo Wang Jian-Hong Xu Yu-Qing Jia Department of General Surgery Yangzhou Friendship Hospital Affiliated to Medical College of Yangzhou UniversityYangzhou 225000Jiangsu ProvinceChina

BACKGROUND This study was designed to investigate the clinical efficacy and safety of Gamma Knife®combined with transarterial chemoembolization(TACE)and immunotherapy in the treatment of primary liver *** To investigate the clinical efficacy and safety of Gamma Knife®combined with TACE and immune-targeted therapy in the treatment of primary liver *** Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively *** patients underwent Gamma Knife®treatment combined with TACE and *** clinical efficacy,changes in liver function,overall survival(OS),and progression-free survival(PFS)of patients with different treatment responses were evaluated,and adverse reactions were *** The last follow-up for this study was conducted on October 31,*** evaluation of the 51 patients with primary liver cancer revealed a partial response(PR)in 27 patients,accounting for 52.94%(27/51);stable disease(SD)in 16 patients,accounting for 31.37%(16/51);and progressive disease(PD)in 8 patients,accounting for 15.69%(8/51).The objective response rate was 52.94%,and the disease control rate was 84.31%.Alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment(all P=0.000).The median OS was 26 months[95%confidence interval(95%CI):19.946-32.054]in the PR group and 19 months(95%CI:14.156-23.125)in the SD+PD group,with a statistically significant difference(P=0.015).The median PFS was 20 months(95%CI:18.441-34.559)in the PR group and 12 months(95%CI:8.745-13.425)in the SD+PD group,with a statistically significant difference(P=0.002).Common adverse reactions during treatment included nausea and vomiting(39.22%),thrombocytopenia(27.45%),and leukopenia(25.49%),with no treatment-related deaths *** Gamma Knife®combined with TACE and immune-targeted th

关键词： Gamma Knife® transarterial chemoembolization Immunotherapy Primary liver cancer Liver function

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Short-term efficacy assessment of transarterial chemoembolization combined with radioactive iodine therapy in primary hepatocellular carcinoma

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World Journal of Gastrointestinal Surgery 2023年第1期15卷 105-113页

作者： Lei Wang Kun Huang Yu Zhang Yi-Fan Wu Zhen-Dong Yue Zhen-Hua Fan Fu-Quan Liu Yong-Wu Li Jian Dong Department of Interventional Radiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Department of Radiology Chinese Medical University Affiliated First HospitalShenyang 110001Liaoning ProvinceChina Department of Nuclear Medicine The Fifth Center of People’s Liberation Army General HospitalBeijing 100071China Department of Radiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

BACKGROUND transarterial chemoembolization(TACE)is an effective treatment for primary hepatocellular carcinoma(PHC).Radioactive iodine therapy has been used in the treatment of advanced PHC,especially in patients with portal vein tumor ***,data on the therapeutic effect of TACE combined with radioactive iodine therapy in PHC are *** To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC via perfusion computed tomography(CT).METHODS For this study,98 advanced PHC patients were recruited and divided randomly into the study and control *** in the study group were treated with TACE combined radioactive iodine implantation *** in the control group were treated with only *** tumor lesion length,clinical effect,serum alpha-fetoprotein(AFP)and CT perfusion parameters were compared before and after therapy,and statistical analysis was *** There was no significant difference in tumor length and serum AFP between the study and control groups(P>0.05)before ***,the tumor length and serum AFP in the study group were lower than those in the control group 1 mo and 3 mo after *** 3 mo of treatment,the complete and partial remission rate of the study group was 93.88%,which was significantly higher than the control group(77.55%)(P0.05).After 3 mo of treatment,all perfusion CT variables were lower in the study group compared to the control group(P<0.05).The survival time of patients in the study group was 22 mo compared to 18 mo in the control group,which was significantly different[log rank(Mantel-Cox)=4.318,P=0.038].CONCLUSION TACE combined with radioactive iodine implantation in the treatment of advanced PHC can in

关键词： transarterial chemoembolization Radioactive iodine Primary hepatocellular carcinoma Perfusion Computed tomography

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Predictors of liver failure after transarterial chemoembolization in patients with spontaneously ruptured hepatocellular carcinoma:A retrospective study

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Journal of Interventional Medicine 2023年第1期6卷 35-40页

作者： Zhuofan Deng Yunbing Wang Department of Hepatobiliary Surgery The Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina

Background: Spontaneously ruptured hepatocellular carcinoma(rHCC) is a life-threatening condition. transarterial chemoembolization(TACE) is a widely accepted treatment;however, it can lead to serious complications,especially liver failure. We sought to identify preoperative predictors of liver failure in patients with rHCC undergoing ***: Patients with rHCC who received TACE as the initial therapy were retrospectively studied at our institution between January 2016 and December 2021. Based on the occurrence of liver failure after TACE, the patients were divided into liver failure and no-liver failure groups. Predictors of liver failure after TACE were analyzed using univariate and multivariate regression analyses. The predictive performance was assessed using the area under the curve(AUC). Delong’s test was used to compare predictive ***: Sixty patients(19 and 41 in the liver failure and non-liver failure groups, respectively) were *** analysis showed that preoperative prothrombin activity(PTA) level(odds ratio [OR], 0.956;95%confidence interval [CI], 0.920–0.994;P = 0.024) and Child-Pugh grade B(OR, 6.419;95% CI, 1.123–36.677;P= 0.037) were independent predictors of liver failure after TACE in patients with rHCC. The AUCs of the preoperative PTA levels and Child-Pugh grade B for predicting liver failure after TACE in patients with rHCC were0.783 and 0.764, ***: Preoperative PTA level and Child-Pugh grade B were significant independent risk factors for liver failure after TACE in patients with rHCC. These can be used to predict liver failure after TACE in patients with rHCC for individual decision-making regarding treatment planning.

关键词： Hepatocellular carcinoma Spontaneous rupture transarterial chemoembolization Liver failure

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Sorafenib plus transarterial chemoembolization vs sorafenib alone for patients with advanced hepatocellular carcinoma: A systematic review and meta-analysis

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World Journal of Hepatology 2024年第1期16卷 91-102页

作者： Hong-Jie Yang Bin Ye Jia-Xu Liao Lei Lei Kai Chen Department of Radiology The Sixth People's Hospital of ChengduChengdu 610000Sichuan ProvinceChina Department of Oncology The Sixth People's Hospital of ChengduChengdu 610000Sichuan ProvinceChina Department of Pharmacy The Affiliated Taizhou People's Hospital of Nanjing Medical UniversityTaizhou 225300Jiangsu ProvinceChina

BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC *** comparative trials have been conducted to study whether transarterial chemoembolization(TACE)could improve clinical outcomes in patients receiving sorafenib for advanced HCC;however,the findings have been *** To study the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC,by performing a systematic review and *** This study was conducted following the PRISMA statement.A systematic literature search was conducted using the Cochrane Library,Embase,PubMed,and Web of Science *** included in the present work were collected from patients diagnosed with advanced HCC receiving sorafenib plus TACE or sorafenib *** synthesis and meta-analysis were conducted using Review Manager *** The present study included 2780 patients from five comparative clinical trials(1 was randomized control trial and 4 were retrospective studies).It was found that patients receiving sorafenib plus TACE had better prognoses in terms of overall survival(OS),with a combined hazard ratio(HR)of 0.65[95%confidence interval(95%CI):0.46–0.93,P=0.02,n=2780].Consistently,progression free survival(PFS)and time to progression(TTP)differed significantly between the sorafenib plus TACE arm and sorafenib arm(PFS:HR=0.62,95%CI:0.40–0.96,P=0.03,n=443;TTP:HR=0.73,95%CI:0.64-0.83,P<0.00001,n=2451).Disease control rate(DCR)was also significantly increased by combination therapy(risk ratio=1.36,95%CI:1.02-1.81,P=0.04,n=641).Regarding safety,the incidence of any adverse event(AE)was increased due to the addition of TACE;however,no significant difference was found in grade≥3 *** The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy,as evidenced by prolonged OS,PFS,and TTP,as well as increase

关键词： Hepatocellular carcinoma Sorafenib transarterial chemoembolization Systematic review Meta-analysis

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Combined transarterial chemoembolization and stereotactic body radiation therapy as a bridge therapy to liver transplant for hepatocellular carcinoma

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Hepatoma Research 2020年第8期6卷 36-45页

作者： Bui Quang Bieu Nguyen Dinh Chau Nguyen Xuan Kien Le Van Thanh Vu Van Quang Thai Doan Ky Nguyen Tien Thinh Mai Hong Bang Department of Radiation Oncology and Radiosurgery Military Central Hospital 108Hanoi 100000Vietnam Department of Hepatobiliary and Pancreatic Surgery Military Central Hospital 108Hanoi 100000Vietnam Department of Gastroenterology and Hepatobiliary Military Central Hospital 108Hanoi 100000Vietnam.

Liver transplant(LT)is the curative treatment for patients with hepatocellular carcinoma(HCC).Bridge therapies are local treatments given to patients on the LT waitlist,to prevent tumor progression and to reduce the dropout *** presentation:We reported a 40-year-old man diagnosed with Barcenola-Clinic Liver Cancer BCLC intermediate stage HCC and Child-Pugh A5 hepatitis B virus cirrhosis who underwent combined bridge therapies to ***,the patient received transarterial chemoembolization(TACE)for two times and showed a partial *** he underwent stereotactic body radiation therapy(SBRT)with a total dose of 45 Gy in 3 *** months later,the tumor size and serum protein induced by Vitamin K absence or antagonists-II,alpha fetoprotein levels decreased *** June 2019 a suitable donor was found and his LT was successfully ***:We propose that a combination of TACE and SBRT was feasible as bridge therapy for HCC patients on the LT waitlist.

关键词： transarterial chemoembolization stereotactic body radiation therapy bridge therapy hepatocellular carcinoma liver transplant

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Impact of alcohol consumption on treatment outcome of hepatocellular carcinoma patients with viral hepatitis who underwent transarterial chemoembolization

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World Journal of Hepatology 2022年第6期14卷 1162-1172页

作者： Attapon Rattanasupar Arunchai Chang Tanaporn Prateepchaiboon Nuttanit Pungpipattrakul Keerati Akarapatima Apiradee Songjamrat Songklod Pakdeejit Varayu Prachayakul Teerha Piratvisuth Division of Gastroenterology Department of Internal MedicineHatyai HospitalHatyai 90110SongkhlaThailand Department of Internal Medicine Hatyai HospitalHatyai 90110SongkhlaThailand Division of Intervention Radiology Department of RadiologyHatyai HospitalHatyai 90110SongkhlaThailand Siriraj Gastrointestinal Endoscopy Center Division of GastroenterologyDepartment of Internal MedicineFaculty of MedicineSiriraj HospitalMahidol UniversityBangkoknoi 10700BangkokThailand NKC Institute of Gastroenterology and Hepatology Songklanagarind HospitalFaculty of MedicinePrince of Songkla UniversityHatyai 90110SongkhlaThailand

BACKGROUND Alcohol consumption increases the risk of hepatocellular carcinoma(HCC)in patients with pre-existing liver disease,including viral ***,studies on the impact of alcohol consumption on the outcomes of HCC are *** hypothesized that alcohol had an additional effect with chronic viral hepatitis infection on treatment outcomes after transarterial chemoembolization(TACE)in patients with intermediate-stage HCC(Barcelona Clinical Liver Cancer[BCLC]-B).AIM To evaluate the additional effect of alcohol on treatment outcomes of TACE among HCC patients with viral *** This study,conducted at Hatyai Hospital in Thailand,included HCC patients over 18 years of age with chronic viral *** of HCC patients with viral hepatitis classified as BCLC-B who underwent TACE as the first treatment modality between 2014 and 2019 were retrospectively *** with chronic viral hepatitis only were categorized under group A,and those with chronic viral hepatitis and concurrent alcohol consumption were categorized under group *** groups were compared,and the Cox proportional-hazards model was used to identify the survival-influencing *** Of the 69 patients,53 were categorized in group A and 16 in group *** were no statistically significant differences in tumor characteristics between the two patient ***,Group A had a statistically significantly higher proportion of complete response(24.5%vs 0%,P=0.030)and a higher median survival rate(26.2 mo vs 8.4 mo;log-rank P=0.012)compared to group *** associated with decreased survival in the proportional-hazards model included alcohol consumption(hazards ratio[HR],2.377;95%confidence interval[CI],1.109-5.095;P=0.026),presence of portal hypertension(HR,2.578;95%CI,1.320–5.037;P=0.006),largest tumor size>5 cm(HR,3.558;95%CI,1.824-6.939;P100 ng/mL(HR,2.536;95%CI,1.377-4.670;P=0.003).CONCLUSION In HCC BCLC B patients

关键词： Alcohol misuse Chronic viral hepatitis Hepatocellular carcinoma Risk factor Survival transarterial chemoembolization

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Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma

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World Journal of Hepatology 2017年第18期9卷 808-814页

作者： Jeong Eun Song Do Young Kim Department of Internal Medicine Yonsei University College of MedicineSeoul 120-752South Korea

transarterial chemoembolization(TACE) is the current standard of therapy for patients with intermediatestage hepatocellular carcinoma(HCC) according to the Barcelona Clinic Liver Cancer classification. The concept of conventional TACE(cTACE) is the selective obstruction of tumor-feeding artery by injection of chemotherapeutic agents, leading to ischemic necrosis of the target tumor via cytotoxic and ischemic effects. Drugeluting beads(DEBs) have been imposed as novel drugdelivering agents for TACE, which allows for higher concentrations of drugs within the target tumor and lower systemic concentrations compared with cTACE. Despite the theoretical advantages of DEB-TACE, it is still controversial in clinical practice as to whether DEBTACE is superior to cTACE in regard to overall survival and treatment response. In this review article, we summarize the clinical efficacy and safety of DEB-TACE for patients with intermediate or advanced stage HCC in comparison with cTACE.

关键词： Hepatocellular carcinoma Drug-eluting beads transarterial chemoembolization transarterial chemoembolization

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Stratification of portal vein-invaded hepatocellular carcinoma treated with transarterial chemoembolization monotherapy

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Journal of Interventional Medicine 2020年第4期3卷 201-207页

作者： Lei Zhang BinYan Zhong Bo Hu Wei Li Peng Huang Shen Zhang JinJin Song JianSong Ji CaiFang Ni Department of Interventional Radiology The First Affiliated Hospital of Soochow UniversitySuzhouChina Department of Interventional Radiology Zhejiang University Lishui HospitalThe Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Central HospitalLishuiChina

Purpose:The study aimed to establish a prognostic prediction model and an artificial neural network(ANN)model to determine who will benefit from transarterial chemoembolization(TACE)monotherapy for patients with hepatocellular carcinoma(HCC)invading portal ***:Treatment-naive patients with HCC and portal vein invasion who were treated with TACE monotherapy at hospital A as training cohort and hospital B as validation cohort were *** primary endpoint was overall survival(OS).In training cohort,independent risk factors associated with OS were identified by univariate and multivariate *** prognostic prediction(PP)and ANN models based on the independent risk factors were established to find out who will benefit most from TACE *** type of portal vein tumor thrombosis was classified based on the Cheng’s *** accuracy of the models was validated in validation ***:Totally,242 patients(training cohort:n=159;validation cohort:n=83)were *** median OS was 7.1 and 8.5 months in training and validation cohort,*** training cohort,the PP model was established based on the following five independent risk factors:Cheng’s Classification,Eastern Cooperative Oncology Group score,maximum tumor size,number of HCC nodules,and Child-Pugh *** score of 17.5 was identified as cut-off point and patients were divided into two groups by PP score17.5 in survival benefit and prognostication(8.8 vs.5.5 months;P<0.001).These five factors were included and ranked based on the importance associated with OS in the ANN *** of the two models received high accuracy after ***:Portal vein invaded HCC patients with PP score<17.5 may benefit most from TACE *** these patients,TACE monotherapy should be considered.

关键词： Hepatocellular carcinoma transarterial chemoembolization Portal vein tumor thrombosis Prognostic Artificial neural network

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Conventional versus drug-eluting bead transarterial chemoembolization:A better option for treatment of unresectable hepatocellular carcinoma

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Journal of Interventional Medicine 2021年第1期4卷 11-14页

作者： Murtuza Razi Gu Jianping He Xu Mohammed Jameeluddin Ahmed Department of Interventional Radiology Nanjing Medical University Third School of Clinical MedicineNanjing First HospitalNanjingJiangsu210006China

transarterial chemoembolization(TACE) is a minimally invasive procedure involving intra-arterial catheter-based chemotherapy to selectively administer high doses of cytotoxic drugs to the tumor bed along with ischemic necrosis induced by arterial *** forms the essential core of management in patients with hepatocellular carcinoma(HCC) who are not suitable for curative therapies such as transplantation,resection,or percutaneous *** of hepatic cancer(s) has proven to be helpful in achieving local tumor control,and has supported the ability to prevent tumor progression,prolong patient life,and manage patient *** data have demonstrated that,in patients with single-nodule HCC ≤3 cm without vascular invasion,the 5-year overall survival with TACE was found to be comparable with hepatic resection and radiofrequency *** for several years,Lipiodol continues to play a vital role as a tumor-seeking and radiopaque drug delivery vector in interventional *** have been made to enhance the administration of chemotherapeutic agents to *** with conventional TACE,drug-eluting bead TACE is a fairly new drug delivery embolization technique that permits fixed dosing and has the ability to provide sustained release of anticancer agents over a period of *** present review discusses the basic procedure of TACE and its properties,and the effectiveness of conventional and drug-eluting bead chemoembolization systems currently available or presently undergoing clinical evaluation.

关键词： transarterial chemoembolization Drug-eluting bead Hepatocellular carcinoma

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Impact of Different Embolic Agents for transarterial chemoembolization (TACE) Procedures on Systemic Vascular Endothelial Growth Factor (VEGF) Levels

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Journal of Clinical and Translational Hepatology 2016年第4期4卷 288-292页

作者： Andreas Schicho Claus Hellerbrand Kristina Krüger Lukas P.Beyer Walter Wohlgemuth Christoph Niessen Ernst Hohenstein Christian Stroszczynski Philippe L.Pereira Philipp Wiggermann Department of Radiology University Hospital Regensburg Regensburg Germany Friedrich-Alexander University Erlangen-Nürnberg Institute of Biochemistry(Emil-Fischer Zentrum) Erlangen Germany Clinic for Radiology Minimally-invasive Therapies and Nuclear Medicine SLK Kliniken Heilbronn GmbH Heilbronn Germany

Background and Aims:Intermediate stage hepatocellular carcinoma (HCC) can be treated by transarterial chemoem-bolization (TACE).However,there appear to be side effects,such as induction of proangiogenic factors,*** endothelial growth factor (VEGF),which have been shown to be associated with a poor *** prospective study was designed to compare serum VEGF level response after TACE with different embolic agents in patients with ***:Patients were assigned to one of three different TACE regimens:degradable starch microspheres (DSM) TACE,drugeluting bead (DEBDOX) TACE or Lipiodol TACE (cTACE).All patients received 50 mg doxorubicin/m2 body surface area (BSA) during *** VEGF levels were assessed before TACE treatment,24 h post-treatment and 4 weeks ***:Twenty-two patients with 30 TACE treatments were *** to baseline VEGF levels,a marked increase was observed for 24 h post-TACE (164% of baseline level) and during the 4-week follow-up (170% of baseline level) only for the cTACE arm (p < 0.05).In contrast,the increase of serum VEGF levels were only 114% and 123% for DEBDOX and 121% and 124% for DSM,***:Conventional TACE using Lipiodol shows marked increase in blood levels of the proangiogenic factor VEGF,while DEBDOX and DSM TACE induce only a moderate VEGF response.

关键词： transarterial chemoembolization Vascular endothelial growth factor Embolic agents Hepatocellular carcinoma Angiogenesis

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