BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world and ranks the third most common cause of cancer-related death. Surgical resection, liver transplantation and percutane...BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world and ranks the third most common cause of cancer-related death. Surgical resection, liver transplantation and percutaneous ablation are generally considered the only curative treatment for early stage HCC. Besides the limitations of insufficient organ donors and a long waiting time for liver transplantation, however, resection is applied only to patients with good hepatic reserve and localized tumors, with a resectability of 30%. DATA SOURCES: Local ablation therapy, which is minimally invasive but contributes to the significant improvement of survival in patients with unresectable tumor, hasbeen widely used in treating small HCC. Among the techniques of local therapy, percutaneous ethanol injection (PEI) with a complete response in 80% of HCCs less than 3 cm has been accepted as an alternative to surgery in patients with small HCC. Moreover, percutaneous hepatic quantified ethanol injection (PHQEI) or PEI according to the standard criteria has been confirmed to benefit patients with HCC, especially when quantified ethanol is given at a short interval (QESI, the interval was 2-3 days). RESULT: Several limitations related to local percutaneous methods may result in incomplete therapeutic effect in case of larger HCC nodules (>3 cm). CONCLUSION: The combined use of different methods according to the clinical status of patients or tumors may be essential to the effective treatment of HCC.展开更多
Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performe...Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performed in 57 patients with MHCC, which were randomly divided into group A （n = 28） and group B （n = 29）. Patients in the group A received conventional TACE for the first time and then received low dose TACE （10 mg mitomycin C） for the repeated treatment, Re-examined CT scans after TACE for a week. Based on filled status of Lipiodol in the Lesions, PAl was underwent in the area of rarefaction or defect filled by Lipiodol. Patients in the group B received conventional TACE. Then The survival rate and masses variation and hepatic function and a-FP and side effects were observed. Results： The 1-, 2- and 3-year survival rate after TACE were 96.4%, 78.6% and 32.1% for group A, and 65.5%, 48.3% and 20.7% for group B. Masses diminution were found in all patients in group A, while 20 cases were found in group B, unchanged in 5 cases and enlarged in 4 cases. Conclusion： The efficacy of TACE combined with PAl are significantly better than that of TACE only, low dose TACE produces less hepatic damage and less side effect.展开更多
文摘BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world and ranks the third most common cause of cancer-related death. Surgical resection, liver transplantation and percutaneous ablation are generally considered the only curative treatment for early stage HCC. Besides the limitations of insufficient organ donors and a long waiting time for liver transplantation, however, resection is applied only to patients with good hepatic reserve and localized tumors, with a resectability of 30%. DATA SOURCES: Local ablation therapy, which is minimally invasive but contributes to the significant improvement of survival in patients with unresectable tumor, hasbeen widely used in treating small HCC. Among the techniques of local therapy, percutaneous ethanol injection (PEI) with a complete response in 80% of HCCs less than 3 cm has been accepted as an alternative to surgery in patients with small HCC. Moreover, percutaneous hepatic quantified ethanol injection (PHQEI) or PEI according to the standard criteria has been confirmed to benefit patients with HCC, especially when quantified ethanol is given at a short interval (QESI, the interval was 2-3 days). RESULT: Several limitations related to local percutaneous methods may result in incomplete therapeutic effect in case of larger HCC nodules (>3 cm). CONCLUSION: The combined use of different methods according to the clinical status of patients or tumors may be essential to the effective treatment of HCC.
文摘Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performed in 57 patients with MHCC, which were randomly divided into group A （n = 28） and group B （n = 29）. Patients in the group A received conventional TACE for the first time and then received low dose TACE （10 mg mitomycin C） for the repeated treatment, Re-examined CT scans after TACE for a week. Based on filled status of Lipiodol in the Lesions, PAl was underwent in the area of rarefaction or defect filled by Lipiodol. Patients in the group B received conventional TACE. Then The survival rate and masses variation and hepatic function and a-FP and side effects were observed. Results： The 1-, 2- and 3-year survival rate after TACE were 96.4%, 78.6% and 32.1% for group A, and 65.5%, 48.3% and 20.7% for group B. Masses diminution were found in all patients in group A, while 20 cases were found in group B, unchanged in 5 cases and enlarged in 4 cases. Conclusion： The efficacy of TACE combined with PAl are significantly better than that of TACE only, low dose TACE produces less hepatic damage and less side effect.
