Hepatic arterial infusion chemotherapy for hepatocellular carcinoma with portal vein tumor thrombosis

AIM: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with poor prognosis. The aim of this prospective study was to evaluate the efficacy of hepatic arterial infusion chemotherapy (HAIC) for patients with this disease.METHODS: Eighteen HCC patients with PVTT were treated with HAIC via a subcutaneously implanted injection port. A course of chemotherapy consisted of daily cisplatin (10 mg for one hour) followed by 5-fiuorouracil (250 mg for five hours) zfor five continuous days within a given week. The patients were scheduled to receive four consecutive courses of HAIC.Responders were defined in whom either a complete or partial response was achieved, while non-responders were defined based on stable or progressive disease status. The prognostic factors associated with survival after treatment were analyzed.RESULTS: Six patients exhibited partial response to this form of HAIC (response rate = 33 %). The 3, 6, 9, 12 and 18-month cumulative survival rates for the 18 patients were 83 %, 72 %, 50 %, 28 %, and 7 %, respectively. Median survival times for the six responders and 12 non-responders were 15.0 (range, 11-18) and 7.5 (range, 1-13) months,respectively, It was demonstrated by both univariate and multivariate analyses that the therapeutic response and hepatic reserve function were significant prognostic factors.CONCLUSION: HAIC using low-dose cisplatin and 5-fluorouracil may be a useful alternative for the treatment of patients with advanced HCC complicated with PVTT. There may also be survival-related benefits associated with HAIC.

Portal vein pulsatility index is a more important indicator than congestion index in the clinical evaluation of right heart function

瞄准：在充血心力衰竭学习门血流的变化。方法：我们用超声的 Doppler 与充血心力衰竭的改变的度在病人学习了拥挤索引(CI ) 和门静脉 pulsatility 索引(PI ) 。十个病人与(平均数) 在就，伊朗的银币迫使(RA )【 10 毫米汞柱作为组 1 被分类并且留下有 RA 】 或 = 的 10 个病人是的 10 毫米汞柱组 2。结果：心指数上没有差别(嗨， P=0.28 )，主动脉压( AO ， P=0.78 )，左室的结束心脏舒张的压力( LVED ， P=0.06 )，(最大) i 妈妈门血速度( Vmax ， P=0.17 )，(平均数)门血速度( Vmean ， P=0.15 )并且门血流体积( PBF ， P=0.95 )在二个组之间。组 2 病人有更高肺的楔压力( PW ， 29.9+/-9.3 毫米汞柱对 14.6+/-7.3 毫米汞柱， P=0.002 )，肺的动脉压( PA ， 46.3+/-13.2 毫米汞柱对 25.0+/-8.2 毫米汞柱， P=0.004 )， RA ( 17.5+/-5.7 毫米汞柱对 4.7+/-2.4 毫米汞柱， P【0.001 )，恰好室的结束心脏舒张的压力( RVED ， 18.3+/-5.6 毫米汞柱对 6.4+/-2.7 毫米汞柱， P【0.001 )， CI ( 8.7+/-2.4 对 5.8+/-1.2 ， P=0.03 )，并且 PI (87.8+/-32.3%对27.0+/-7.4%， P【0.001 )与组织 1 比。 CI 与 PI ( P【0.001 )被相关， PW ( P【0.001 )， PA ( P【0.001 )， RA ( P=0.043 )， RVED ( P=0.005 )，嗨( P【0.001 )， AO ( P【0.001 )，公司( P【0.001 )， LVED ( P【0.001 )， Vmax ( P【0.001 )， Vmean ( P【0.001 )，主要的门静脉( P【0.001 )的代表性的区域和 PBF ( P【0.001 )。CI 能在有 RA 【 的病人象 8.3 一样高 10 毫米汞柱并且与 RA 】 或 = 象 5.9 一样在那些低 10 毫米汞柱。结论：我们 RI 比在高 RA 】 或 = 的临床的评估的 CI 是更重要的指示物的数据表演 10 毫米汞柱，而 CI 比在对左心的评价的 PI 好，工作。