• Title/Summary/Keyword: Chemoembolization

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Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A)

  • Lee, Hyukjoon;Yoon, Chang Jin;Seong, Nak Jong;Jeong, Sook-Hyang;Kim, Jin-Wook
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1130-1139
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    • 2018
  • Objective: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). Materials and Methods: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. Results: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. Conclusion: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.

The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization (체위변경이 간동맥 화학색전술 환자의 요통, 불편감, 출혈 합병증에 미치는 효과)

  • Yun, Mi-Jeong;Min, Hye Sook
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.424-433
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    • 2014
  • Purpose: This study was to test the effects of the positional change on low back pain, discomfort, and bleeding complications during the period of bed rest following transarterial chemoembolization (TACE). Methods: The research design for this study was a non-equivalent control group quasi-experimental design. The participants were 23 patients for the experimental group, and 23 patients for the control group. The experimental group received positional change of taking the semi-Fowler's position and the 30-degree lateral position alternatively during the period of bed rest after TACE for 4 hours at one-hour intervals. The control group maintained the supine position continuously during the period of bed rest after TACE. Results: There were statistically significant differences in low back pain and discomfort between the experimental and the control group after intervention. And no significant difference was found in bleeding complication between two groups. Conclusion: The results of the study suggest that the positional change is an effective nursing intervention to reduce low back pain and discomfort without increasing the risk of bleeding after TACE.

Effect of Bed Side Exercising on Back Pain and Bleeding Complications after Transcatheter Arterial Chemoembolization (간동맥 화학색전술 후 절대안정기간 동안의 침상운동요법이 요통과 출혈합병증에 미치는 효과)

  • Nam, Sun Hee;Kim, Young-Ju
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.400-408
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    • 2013
  • Purpose: This study was conducted to examine the effects of bed side exercising on back pain and bleeding during absolute bed rest in patients who had received transcatheter arterial chemoembolization (TACE). Methods: A nonequivalent control group pretest-posttest design was used. A total 46 patients were sampled from a gastrointestinal unit of a urban general hospital in Seoul. The control group received 8 hours of bed rest and conservative care. The experimental group received 8 hours of bed rest and bed side exercising every one hour from the time having absolute bed rest for 3 hours after TACE. Results: The experimental group with bed side exercising experienced significantly less back pain compared to the control group. There was no significant difference in the incidence of bleeding complications between two groups. Conclusion: The results indicate that a bed side exercising is associated with a reduction of back pain and with no increased risk of bleeding complications in patients after TACE.

Lobaplatin Combined Floxuridine/Pirarubicin-based Transcatheter Hepatic Arterial Chemoembolization for Unresectable Primary Hepatocellular Carcinoma

  • Zhao, Chang;Wang, Xu-Jie;Wang, Song;Feng, Wei-Hua;Shi, Lei;Yu, Chun-Peng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2057-2060
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    • 2014
  • Purpose: To assess the effect and safety of lobaplatin combinated floxuridine /pirarubicin in transcatheter hepatic arterial chemoembolization(TACE) of unresectable primary liver cancer. Patients and Methods: TACE combined with the chemotherapy regimen was used to treat 34 unresectable primary liver cancer patients. DSA/MRI/CT/blood routine examinations were used to evaluate short term activity and toxicity after 4-5 weeks, the process being repeated if necessary. Results: Among the 34 cases, 1 (2.9%) showed a complete response, 21 (61.7%) a partial response, 8 (23.5%) stable disease, and 4 progressive disease, with a total effective rate of 67.6%. The content of alpha fetoprotein dropped by over 50% in 20 cases (58.8%). The rate of recovery was hepatalgia (88.2%), ascites (47.1%), appetite (55.9%), Performance Status(30.4%). The median follow-up time (MFT) was 281 days (63-558 days), and median progression-free survival was 118.5 days (95%, CI:88.8-148.2days). Adverse reactions (III-IV grade) were not common, with only 4 cases of vomiting and 2 cases of thrombocytopenia (III grade). Conclusions: Lobaplatin-based TACE is an effective and safe treatment for primary liver cancer.

Pulmonary Lipiodol Embolism after Transcatheter Chemoembolization for Hepatocellular Carcinoma

  • Park, Woo-Ri;Kim, Jung-Tae;Han, Hye-Suk;Kim, Sung-Jin;Choe, Kang-Hyeon;Lee, Ki-Man;An, Jin-Young
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.50-54
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    • 2011
  • Pulmonary lipiodol embolism is a rare but very fatal complication of transcatheter arterial chemoembolization (TACE), Here we present the case of an unusual complication of TACE in a 67-year-old man who presented with dyspnea, hemoptysis, and a history of a third session of TACE for hepatocellular carcinoma (HCC) that had been performed 3 days prior to presenting. On the basis of chest X-ray and computed tomography (CT) scan findings, we diagnosed pulmonary lipiodol embolism. He was conservatively treated with oxygen and haemostatic agents. The patient recovered quickly without any significant sequela and was discharged.

Quality of Life of Hepatocellular Carcinoma Patients with Transarterial Chemoembolization (간동맥화학색전술 치료를 받는 간세포암 환자의 삶의 질 관련요인)

  • Kim, Du-Mi;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.26 no.1
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    • pp.46-53
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    • 2019
  • Purpose: The aim of this study was to examine the quality of life (QOL) and its associated factors in hepatocellular carcinoma patients with Transarterial Chemoembolization. Methods: A descriptive correlational study was used, 106 hepatocellular cancer patients participated through convenient sampling. Data were collected by self-report questionniares or face to face interviews during the period from June to December in 2014. Satisfaction for pain control, perceived health status, professional support and QOL were measured by Assessment of Patient Satisfaction for Pain Management, Health Self-Rating, Relationship Questionnaire, Functional Assessment Cancer Therapy-General. Results: The mean age of participants was 63.7 years and most of them were male (86.8%) and married (84.9%). The mean score of QOL was 67.42. QOL was significantly different by religion. Number of other disease and perceived health status were positively correlated to QOL. Pain intensity was negatively correlated to QOL. As a result of stepwise multiple regression analysis, perceived health status and religion were explained 41.0% (p<.001) of the variance in QOL. Conclusion: Perceived health status should be considered when developing nursing intervention to improve QOL among hepatocellular cancer patients with Transarterial Chemoembolization.

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

  • Yasir M. Nouri;Jin Hyoung Kim;Hyun-Ki Yoon;Heung-Kyu Ko;Ji Hoon Shin;Dong Il Gwon
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.34-49
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    • 2019
  • Conventional transcatheter arterial chemoembolization (c-TACE) is a widely used first-line palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). Despite the effectiveness of c-TACE, to date, technique and procedure scheduling has not yet been standardized. Drug-eluting microspheres (DEMs) were therefore introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization. These DEMs can load various drugs and release them in a sustained manner over a prolonged period. This approach ensures the delivery of high concentrations of chemotherapeutic agents to tumors, without increasing systemic concentrations, and promote tumor ischemia and necrosis. This review summarizes the recent advances in the use of DEM-TACE to treat HCC.

Liver Fibrosis and Five Year Survival of Hepatocellular Cancer Cases Undergoing Transcatheter Arterial Chemo Embolization Using Small Doses

  • Li, Hong;Hu, Yaohong;Li, Na;Zhou, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1589-1593
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    • 2012
  • Objective: To investigate liver fibrosis, TGF-${\beta}1$ levels and curative effects on hepatocellular carcinoma (HCC) with small and conventional dose perfusion chemotherapy by transcatheter arterial chemo embolization (TACE). Methods: Thirty-six hepatocellular carcinoma patients not indicated for surgical resection underwent super-selective transcatheter arterial chemoembolization, divided into small dose (n=15) and conventional dose (n=21) chemotherapy groups. Results: With conventional doses, four indices of liver fibrosis focusing on hyaluronate acide (HA), human procollagen type-III (hPC-III), collagen type-Ⅳ (Ⅳ-C) and transforming growth factor-${\beta}l$ (TGF-${\beta}1$) were obviously increased postoperative compared with preoperative (P<0.01); in contrast, with small doses there were no significant differences except for TGF-${\beta}1$. Five year survival demonstrated no significant differences between the two groups (P>0.05). Conclusion: To hepatocellular carcinoma patients treated by TACE, reducing doses of chemotherapy drugs can reduce progress of liver fibrosis, without impacting on five year survival.

Clinical Application of Transcatheter Arterial Chemoembolization Combined with Synchronous C-arm Cone-Beam CT Guided Radiofrequency Ablation in treatment of Large Hepatocellular Carcinoma

  • Wang, Zhi-Jun;Wang, Mao-Qiang;Duan, Feng;Song, Peng;Liu, Feng-Yong;Wang, Yan;Yan, Jie-Yu;Li, Kai;Yuan, Kai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1649-1654
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    • 2013
  • Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.