• Title/Summary/Keyword: Therapeutic chemoembolization

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A Case of Cryptogenic Organizing Pneumonia after Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma

  • Kim, Ah ran;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong;Kim, Hee Joung;Kim, Jun Hyun;Rhyu, Yong A
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.469-472
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    • 2015
  • Cryptogenic organizing pneumonia (COP) is an inflammatory lung disease involving the distal bronchioles, respiratory bronchioles, bronchiolar ducts, and alveolae. The etiology is usually unknown; however, there are several known causes and associated systemic diseases. Corticosteroid therapy is the best treatment option and the prognosis of COP is good, with recovery in up to 80% of patients. We described a patient with in-operable hepatocellular carcinoma (HCC) undergoing chemoembolization with doxorubicin in a drug-eluting bead (DEB). COP developed in the patient after chemoembolization but resolved spontaneously in several months.

Application of Lobaplatin in Trans-catheter Arterial Chemoembolization for Primary Hepatic Carcinoma

  • Wang, Nan;Lv, Yin-Zhang;Xu, An-Hui;Huang, Yan-Rong;Peng, Ling;Li, Jia-Rui
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.647-650
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    • 2014
  • Objective: To explore the efficiency of single application of lobaplatin in tran-scatheter arterial chemoembolization (TACE) for patients with a primary hepatic carcinoma who were unable or unwilling to undergo surgery. Methods: 173 patients with primary hepatic carcinoma diagnosed by imaging or pathology were randomly divided into experimental and control groups and respectively treated with lobaplatin and pirarubicin hydrochloride as chemotherapeutic drugs for TACE. The amount of iodipin was regulated according to the tumor number and size, and then gelatin sponge or polyvinyl alcohol particles were applied for embolisms. The efficiency of treatment in the two groups was compared with reference to survival time and therapeutic response. Results: The experimental group (single lobaplatin as chemotherapy drug) was superior to control group (single pirarubicin hydrochloride as chemotherapy drug) in the aspects of survival time and therapeutic response, with statistical significance. Conclusions: Single lobaplatin can be as a chemotherapy drug in TACE and has better efficiency in the aspects of mean survival time and therapeutic response, deserving to be popularized in the clinic.

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.

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.

Efficacy of Transarterial Chemoembolization Combined with Radiofrequency Ablation in Treatment of Hepatocellular Carcinoma

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6159-6162
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    • 2015
  • Purpose: To evaluate efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of patients with hepatocellular carcinoma. Materials and Methods: During January 2009 to March 2012, 80 patients with hepatocellular carcinoma underwent TACE, with or without RFA. Alfafetoprotein (AFP) was checked before and after procedure. CT scans were obtained one month after TACE or RFA for all patients to evaluate tumor changes. Complete response+partial response+stable disease (CR+PR+SD)/n were used to assess the disease control rate (DCR). Survival at 3, 6 and 12 months was compared in both groups. Results: AFP levels in TACE + RFA group dropped rapidly, becoming obviously lower than that of the TACE group. In the TACE + RFA group DCR was 93.8%, while only 76.8% in the TACE group. The treatment effect between the two groups was statistically significant (P<0.05) by Ridit analysis. 1 year survival rate in the TACE + RFA group was 92.5%, significantly higher than that of the TACE group at 77.5% (P<0.05). Conclusions: TACE and RFA as combined therapy method for patients with middle and terminal stage HCC gives full play to synergy between the two and improves the therapeutic effect.

Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma (파열 간암의 간동맥 항암 화학색전술 후 발생한 유도 폐렴)

  • Kim, Haewon;Kim, Yong Hoon;Yoon, Hong Jin;Lee, Kwang Hoon;Joo, Seung Moon;Byun, Min Kwang;Lee, Jung Il;Lee, Kwan Sik;Kim, Ja Kyung
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.117-121
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    • 2014
  • Transarterial chemoembolization (TACE) is a widely accepted nonsurgical modality used for the treatment of multinodular hepatocellular carcinoma (HCC). The careful selection of the candidate is important due to the risk of developing various side effects. Fever, nausea, abdominal pain, and liver enzyme elevation are commonly known side effects of TACE. Hepatic failure, ischemic cholecystitis, and cerebral embolism are also reported, although their incidence might be low. Pulmonary complication after TACE is rare, and the reported cases of lipiodol pneumonitis are even rarer. A 53-year-old man was treated with TACE for ruptured HCC associated with hepatitis B virus infection. On day 19 after the procedure, the patient complained of dyspnea and dry cough. Chest computed tomography showed diffuse ground glass opacities in the whole-lung fields, suggesting lipiodol-induced pneumonitis. After 2 weeks of conservative management, the clinical symptoms and radiologic abnormalities improved. Reported herein is the aforementioned case of lipiodol-induced pnemonitis after TACE, with literature review.

Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association

  • Yuri Cho;Jin Woo Choi;Hoon Kwon;Kun Yung Kim;Byung Chan Lee;Hee Ho Chu;Dong Hyeon Lee;Han Ah Lee;Gyoung Min Kim;Jung Suk Oh;Dongho Hyun;In Joon Lee;Hyunchul Rhim;Research Committee of the Korean Liver Cancer Association
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.606-625
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    • 2023
  • Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

The Clinical Analysis of Primary Malignant Hepatic Tumor in Childhood (소아의 원발성 악성 간종양에 대한 임상적 고찰)

  • Lim, Ki-Yun;Jeong, Yeon-Jun;Jung, Sung-Hoo;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.12-18
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    • 2003
  • The purpose of this study is to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC), were studied. One HCC was resectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. Another unresectable HB patient received systemic chemotherapy instead of TACE before operation. Postoperative chemotherapy was administered to all of the patients after complete surgical resection on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked reduction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotein (${\alpha}$-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the ${\alpha}$-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum ${\alpha}$-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.

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Effects of Exercise on Relief of tow Back Pain in Patients on Absolute Bed Rest after Trans-Arterial Chemoembolization (TAE) (경동맥 화학색전요법 후 절대안정중인 환자의 요통완화를 위한 운동의 효과)

  • Ko, Eun-Ju;Chae, Young-Ran;Lee, Dong-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.2
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    • pp.171-177
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    • 2008
  • Purpose: The aim of study was to identify the effects of exercise on the relief of low back pain in patients on absolute bed rest after TAE. Method: A nonequivalent control group pretest-posttest design research design was used. The participants were 43 patients who had received TAE in a university hospital; patients in the experimental group (21) received both exercise therapy and general post-op nursing care and in the control group (22) only the latter. The exercise program used in this study was modified from exercise for post CABG to exercise for post TAE, which deflect the movement of thigh in which the catheter was inserted, the lumbar region of the back and pelvis. Results: First, Low back pain scores in the experimental group were lower than the control group. Second, The first dose of analgesics in the experimental group was delayed compared to the control group. Third, There was no significant difference in bleeding complications between the experimental group control groups. Conclusion: The results suggest that the exercise program used in this study is effective for relief of low back pain in patients on absolute bed rest after TAE.

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Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular Embolization (Folded-Loop Guidewire Remodeling Technique: 색전술 시 급격한 분지 각도를 가지는 혈관의 선택적 진입 방법)

  • Dong Hyun Kim;Ung Rae Kang;Young Hwan Kim;Jung Guen Cha
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.418-426
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    • 2023
  • Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization. Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery. Results Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.