摘要
This short review summarizes an integrated approach to new methods of managing hepatocellular carcinoma (HCC) developed at our centre. HCC specific isoforms of alpha fetoprotein were detected by isoelectric focusing and their value in the differential diagnosis of early HCC on a background of chronic liver disease has been shown. Selective internal radiation therapy using yttrium 90 ( 90 Y) microspheres has been shown to be an effective treatment for inoperable HCC in a phase Ⅰ and Ⅱ study. A partition model for estimating the radiation doses from the 90 Y microspheres to the tumour and the non tumorous liver during the therapy was then formulated, verified by correlating with intraoperative dosimetry, and evaluated in clinical settings. This permits 90 Y microspheres to be administered safely without the need of an open surgery and a randomized therapeutic controlled trial is in progress. Another radomized controlled trial using iodine 131 Lipiodol as a post operative adjuvant therapy, aiming at reducing the recurrence rate is also on going. HCC may be more effectively combated with a better understanding of its pathogenesis from chronic liver disease.
This short review summarizes an integrated approach to new methods of managing hepatocellular carcinoma (HCC) developed at our centre. HCC specific isoforms of alpha fetoprotein were detected by isoelectric focusing and their value in the differential diagnosis of early HCC on a background of chronic liver disease has been shown. Selective internal radiation therapy using yttrium 90 ( 90 Y) microspheres has been shown to be an effective treatment for inoperable HCC in a phase Ⅰ and Ⅱ study. A partition model for estimating the radiation doses from the 90 Y microspheres to the tumour and the non tumorous liver during the therapy was then formulated, verified by correlating with intraoperative dosimetry, and evaluated in clinical settings. This permits 90 Y microspheres to be administered safely without the need of an open surgery and a randomized therapeutic controlled trial is in progress. Another radomized controlled trial using iodine 131 Lipiodol as a post operative adjuvant therapy, aiming at reducing the recurrence rate is also on going. HCC may be more effectively combated with a better understanding of its pathogenesis from chronic liver disease.
