Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the freq...Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization(TOCE), and hepatic arterial infusion chemotherapy(HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.展开更多
Objective:To investigate the clinical effect of Aidi injection combined with TACE on patients with primary liver cancer and its influence on serum AFP,bFGF,VEGF,inflammatory cytokines,immune function and quality of li...Objective:To investigate the clinical effect of Aidi injection combined with TACE on patients with primary liver cancer and its influence on serum AFP,bFGF,VEGF,inflammatory cytokines,immune function and quality of life.Methods From June 2017 to June 2019,116 patients with primary liver cancer from Shanghai Yangsi hospital and Zhongshan Hospital Affiliated to Fudan University were selected as the study objects.They were randomly divided into TACE group and TACE+Aidi group with 58 cases in each group.The TACE group was treated with TACE.The clinical efficacy,serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life were observed.Results The total effective rate was 89.66%in the case group,which was significantly higher than 74.14%in the TACE group,The difference was statistically significant(P<0.05).After treatment,the levels of alpha-fetoprotein(AFP),carbohydrate chain antigen(CA)242,CA724,basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),transforming growth factor-beta 1(TGF-beta),malondialdehyde(MDA),interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-a,circulating immune complex(CIC),CD8+in the two groups were lower than those before treatment;total antioxidant capacity(TAOC),measurement The levels of superoxide dismutase(SOD),IL-12,CD3+,CD4+,CD4+/CD8+and QOL scores of quality of life were higher than those before treatment.The serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life in theTACE+Aidi group were significantly better than those in the TACE group.The difference was statistically significant(P<0.05).The incidence of adverse reactions in theTACE+Aidi group was 6.89%,which was lower than 13.78%in the TACE group,There was no significant difference(P>0.05).Conclusions Addie injection combined with transcatheter arterial chemoembolization is effective in treating primary liver cancer,reducing serum tumor markers,reducing toxic and side effects,regulating oxidative stress,reducing inflammatory reaction,reducing serum bFGF,VEGF and TGF-beta 1 levels,improving the quality of life of patients,and has high efficiency and safety,which is worthy of further promotion in clinic.展开更多
Background Transarterial chemoembolization （TACE） is the most widely used primary treatment for unresectable hepatocellular carcinoma （HCC） due to its survival benefit, though its clinical effect is still far from...Background Transarterial chemoembolization （TACE） is the most widely used primary treatment for unresectable hepatocellular carcinoma （HCC） due to its survival benefit, though its clinical effect is still far from satisfactory. Jiedufang （JDF） granule preparation is a commonly used Chinese herbal medicine formula for HCC. The aim of this study was to evaluate the effect of combined therapy with TACE and JDF granule preparation in treatment of unresectable HCC on survival. Methods A retrospective study of TACE was performed in 165 patients with unresectable HCC who were admitted between January 2002 and December 2007 in Changhai Hospital, Shanghai, China. Of the 165 patients, 80 patients （study group） received combined therapy consisting of TACE and a long-term maintenance treatment with oral JDF granule preparation, and the remaining 85 patients （control group） received TACE alone. The survival rates of both groups were calculated by the Kaplan-Meier method. Factors possibly affecting survival were assessed by multivariate analysis in the Cox proportional hazard model, such as maximum tumor size, number of lesions, portal vein invasion, and etc. Results The median overall survival was 9.2 months （95% CI： 6.94-11.46） in the study group versus 5.87 months （95% CI： 4.21-7.52） in the control group. In the study group,survival rates of the 1-, 2- and 3-year follow-up were 41.2%, 18.4%, and 9.6%, respectively. Significant independent prognostic factors identified by the Cox regression analysis were as follows： serum hepatitis B surface antigen （HBsAg） （P=0.014）, maximum tumor size （P=0.027）, number of lesions （P 〈0.001）, portal vein invasion （P 〈0.001）, and the therapy model （P=-0.006）. Conclusion Combination therapy of TACE and JDF granule preparation may significantly prolong survival of patients with unresectable HCC.展开更多
Objective： To investigate the therapeutic effects of Jiedu Granules （解毒颗粒）, a Chinese medicine （CM） compound, plus Cinobufacini Injection （华蟾素注射液）, which was extracted from skin of Bufo bufo gargariza...Objective： To investigate the therapeutic effects of Jiedu Granules （解毒颗粒）, a Chinese medicine （CM） compound, plus Cinobufacini Injection （华蟾素注射液）, which was extracted from skin of Bufo bufo gargarizans Cantor, to prevent the recurrence of hepatocellular carcinoma （HCC） after surgical resection. Methods： In this case-control trial, a total of 120 patients who stayed in Changhai Hospital were enrolled from December 2001 to December 2006. Sixty patients were treated with Jiedu Granules plus Cinobufacini Injection to prevent tumor recurrence after operation （CM group） and 60 patients were treated with transcatheter arterial chemoembolization （TACE） after operation （TACE group）. Progression-free survival （PFS） and overall survival （OS） rates were determined to evaluate the therapeutic effects of post-operative management of patients with HCC. Results： PFS in the CM group was 18.07 months [95% confidence interval （CI）： 12.49-23.65] and the 1-, 2-, 3-, 4- and 5-year PFS rates were 61%, 39%, 26%, 22% and 12%, respectively. PFS in the TACE group was 8.03 months （95% CI： 6.63-9.44） and the 1-, 2-, 3-, 4- and 5-year PFS rates were 34%, 11%, 7%, 2% and 0%, respectively. There was significant difference in survival rate between the two groups （P〈0.01）. The mean survival time （MST） of patients in the CM group was 49.53 months versus 39.90 months of the TACE group. The 1-, 2-, 3-, 4- and 5-year survival rates were 90%, 82%, 80%, 70% and 63%, respectively, in the CM group, and 79%, 70%, 60%, 60% and 36%, respectively, in the TACE group. There was significant difference in survival time between the two groups （P=0.045）. Conclusions： Jiedu Granules plus Cinobufacini Injection, a combination that is commonly used for post-operation management of HCC, can postpone tumor recurrence and metastasis, prolong the survival time and increase the survival rate of post-surgical patients with HCC. However, these findings need to be confirmed in a prospective, randomized controlled trial.展开更多
AIM: To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS: HCC patients (n=147) with tumor thrombi in the ...AIM: To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS: HCC patients (n=147) with tumor thrombi in the main portal vein or the first branch of portal vein were divided into four groups by the several therapeutic methods. There were conservative treatment group in 18 out of patients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAI) group in 18 patients (group B), in whom postoperative chemoembolization was done periodically; group of removal of HCC with PVTT in 79 (group C) and group of transcatheter hepatic arterial chemoembolization (TACE) or HAI and/or portal vein infusion (PVI) after operation in 32 (group D). RESULTS: The median survival period was 12 months in our series and the 1-,3-, and 5-year survival rates were 44.3%, 24.5% and 15.2%, respectively. The median survival times were 2, 5, 12 and 16 months in group A, B, C and D, respectively. The 1-, 3- and 5-year survival rates were 5.6%, 0% and 0% in group A; 22.2%, 5.6% and 0% in group B; 53.9%, 26.9% and 16.6% in group C; 79.3%, 38.9% and 26.8% in group D, respectively. Significant difference appeared in the survival rates among the groups (P 【 0.05). CONCLUSION: Hepatic resection with removal of tumor thrombi and HCC should increase the curative effects and be encouraged for the prolongation of life span and quality of life for HCC patients with PVTT, whereas the best therapeutic method for HCC with PVTT is with regional hepatic chemotherapy or chemoembolization after hepatic resection with removal of tumor thrombi.展开更多
Transcatheter hepatic artery chemoembolization(TACE)is a universal treatment for patients with hepatocellular carcinoma(HCC)that inhibits tumor growth by cutting off the blood supply and provides chemotherapeutics loc...Transcatheter hepatic artery chemoembolization(TACE)is a universal treatment for patients with hepatocellular carcinoma(HCC)that inhibits tumor growth by cutting off the blood supply and provides chemotherapeutics locally to the tumor.The strategy of combining TACE formulation with image-guided ablation holds tremendous potential,but patient tolerance and undesired toxicity/immunosuppression remains a challenge.The application of nanotechnology in TACE opens new doors for the treatment of HCC.Strikingly,nanomaterials or nano-drugs dispersed in the TACE formulation can effectively improve the delivery efficiency of drugs by achieving both controlled and continuous release.In addition,the utilization of multifunctional nanoparticles can provide guidance and monitoring for various advanced imaging methods for TACE treatment,and can realize the combination therapy of thermal ablation,microwave ablation,in situ radiotherapy,and other therapies,greatly expanding the therapeutic strategies available for HCC treatment.Here,the current exploration of nanotechnology in TACE of HCC is briefly summarized and the challenges of TACE with nanoformulations for clinical translation are comprehensively discussed.展开更多
文摘Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization(TOCE), and hepatic arterial infusion chemotherapy(HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.
文摘Objective:To investigate the clinical effect of Aidi injection combined with TACE on patients with primary liver cancer and its influence on serum AFP,bFGF,VEGF,inflammatory cytokines,immune function and quality of life.Methods From June 2017 to June 2019,116 patients with primary liver cancer from Shanghai Yangsi hospital and Zhongshan Hospital Affiliated to Fudan University were selected as the study objects.They were randomly divided into TACE group and TACE+Aidi group with 58 cases in each group.The TACE group was treated with TACE.The clinical efficacy,serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life were observed.Results The total effective rate was 89.66%in the case group,which was significantly higher than 74.14%in the TACE group,The difference was statistically significant(P<0.05).After treatment,the levels of alpha-fetoprotein(AFP),carbohydrate chain antigen(CA)242,CA724,basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),transforming growth factor-beta 1(TGF-beta),malondialdehyde(MDA),interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-a,circulating immune complex(CIC),CD8+in the two groups were lower than those before treatment;total antioxidant capacity(TAOC),measurement The levels of superoxide dismutase(SOD),IL-12,CD3+,CD4+,CD4+/CD8+and QOL scores of quality of life were higher than those before treatment.The serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life in theTACE+Aidi group were significantly better than those in the TACE group.The difference was statistically significant(P<0.05).The incidence of adverse reactions in theTACE+Aidi group was 6.89%,which was lower than 13.78%in the TACE group,There was no significant difference(P>0.05).Conclusions Addie injection combined with transcatheter arterial chemoembolization is effective in treating primary liver cancer,reducing serum tumor markers,reducing toxic and side effects,regulating oxidative stress,reducing inflammatory reaction,reducing serum bFGF,VEGF and TGF-beta 1 levels,improving the quality of life of patients,and has high efficiency and safety,which is worthy of further promotion in clinic.
文摘Background Transarterial chemoembolization （TACE） is the most widely used primary treatment for unresectable hepatocellular carcinoma （HCC） due to its survival benefit, though its clinical effect is still far from satisfactory. Jiedufang （JDF） granule preparation is a commonly used Chinese herbal medicine formula for HCC. The aim of this study was to evaluate the effect of combined therapy with TACE and JDF granule preparation in treatment of unresectable HCC on survival. Methods A retrospective study of TACE was performed in 165 patients with unresectable HCC who were admitted between January 2002 and December 2007 in Changhai Hospital, Shanghai, China. Of the 165 patients, 80 patients （study group） received combined therapy consisting of TACE and a long-term maintenance treatment with oral JDF granule preparation, and the remaining 85 patients （control group） received TACE alone. The survival rates of both groups were calculated by the Kaplan-Meier method. Factors possibly affecting survival were assessed by multivariate analysis in the Cox proportional hazard model, such as maximum tumor size, number of lesions, portal vein invasion, and etc. Results The median overall survival was 9.2 months （95% CI： 6.94-11.46） in the study group versus 5.87 months （95% CI： 4.21-7.52） in the control group. In the study group,survival rates of the 1-, 2- and 3-year follow-up were 41.2%, 18.4%, and 9.6%, respectively. Significant independent prognostic factors identified by the Cox regression analysis were as follows： serum hepatitis B surface antigen （HBsAg） （P=0.014）, maximum tumor size （P=0.027）, number of lesions （P 〈0.001）, portal vein invasion （P 〈0.001）, and the therapy model （P=-0.006）. Conclusion Combination therapy of TACE and JDF granule preparation may significantly prolong survival of patients with unresectable HCC.
基金Supported by National Key Technology R&D Program for the 11th Five-Year Plan(No.2006 BAI04A06)
文摘Objective： To investigate the therapeutic effects of Jiedu Granules （解毒颗粒）, a Chinese medicine （CM） compound, plus Cinobufacini Injection （华蟾素注射液）, which was extracted from skin of Bufo bufo gargarizans Cantor, to prevent the recurrence of hepatocellular carcinoma （HCC） after surgical resection. Methods： In this case-control trial, a total of 120 patients who stayed in Changhai Hospital were enrolled from December 2001 to December 2006. Sixty patients were treated with Jiedu Granules plus Cinobufacini Injection to prevent tumor recurrence after operation （CM group） and 60 patients were treated with transcatheter arterial chemoembolization （TACE） after operation （TACE group）. Progression-free survival （PFS） and overall survival （OS） rates were determined to evaluate the therapeutic effects of post-operative management of patients with HCC. Results： PFS in the CM group was 18.07 months [95% confidence interval （CI）： 12.49-23.65] and the 1-, 2-, 3-, 4- and 5-year PFS rates were 61%, 39%, 26%, 22% and 12%, respectively. PFS in the TACE group was 8.03 months （95% CI： 6.63-9.44） and the 1-, 2-, 3-, 4- and 5-year PFS rates were 34%, 11%, 7%, 2% and 0%, respectively. There was significant difference in survival rate between the two groups （P〈0.01）. The mean survival time （MST） of patients in the CM group was 49.53 months versus 39.90 months of the TACE group. The 1-, 2-, 3-, 4- and 5-year survival rates were 90%, 82%, 80%, 70% and 63%, respectively, in the CM group, and 79%, 70%, 60%, 60% and 36%, respectively, in the TACE group. There was significant difference in survival time between the two groups （P=0.045）. Conclusions： Jiedu Granules plus Cinobufacini Injection, a combination that is commonly used for post-operation management of HCC, can postpone tumor recurrence and metastasis, prolong the survival time and increase the survival rate of post-surgical patients with HCC. However, these findings need to be confirmed in a prospective, randomized controlled trial.
基金Surported by the Funds of Hundred Outsdanding Persons project of Shanghai(97BR029)Science and Technology Commission of Shanghai(984419067)
文摘AIM: To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS: HCC patients (n=147) with tumor thrombi in the main portal vein or the first branch of portal vein were divided into four groups by the several therapeutic methods. There were conservative treatment group in 18 out of patients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAI) group in 18 patients (group B), in whom postoperative chemoembolization was done periodically; group of removal of HCC with PVTT in 79 (group C) and group of transcatheter hepatic arterial chemoembolization (TACE) or HAI and/or portal vein infusion (PVI) after operation in 32 (group D). RESULTS: The median survival period was 12 months in our series and the 1-,3-, and 5-year survival rates were 44.3%, 24.5% and 15.2%, respectively. The median survival times were 2, 5, 12 and 16 months in group A, B, C and D, respectively. The 1-, 3- and 5-year survival rates were 5.6%, 0% and 0% in group A; 22.2%, 5.6% and 0% in group B; 53.9%, 26.9% and 16.6% in group C; 79.3%, 38.9% and 26.8% in group D, respectively. Significant difference appeared in the survival rates among the groups (P 【 0.05). CONCLUSION: Hepatic resection with removal of tumor thrombi and HCC should increase the curative effects and be encouraged for the prolongation of life span and quality of life for HCC patients with PVTT, whereas the best therapeutic method for HCC with PVTT is with regional hepatic chemotherapy or chemoembolization after hepatic resection with removal of tumor thrombi.
基金supported by the Major State Basic Research Development Program of China(No.2017YFA0205201)the National Natural Science Foundation of China(Nos.81925019,81422023 and U1705281)+1 种基金the Fundamental Research Funds for the Central Universities(Nos.20720190088 and 20720200019)the Program for New Century Excellent Talents in University,China(No.NCET-13-0502)。
文摘Transcatheter hepatic artery chemoembolization(TACE)is a universal treatment for patients with hepatocellular carcinoma(HCC)that inhibits tumor growth by cutting off the blood supply and provides chemotherapeutics locally to the tumor.The strategy of combining TACE formulation with image-guided ablation holds tremendous potential,but patient tolerance and undesired toxicity/immunosuppression remains a challenge.The application of nanotechnology in TACE opens new doors for the treatment of HCC.Strikingly,nanomaterials or nano-drugs dispersed in the TACE formulation can effectively improve the delivery efficiency of drugs by achieving both controlled and continuous release.In addition,the utilization of multifunctional nanoparticles can provide guidance and monitoring for various advanced imaging methods for TACE treatment,and can realize the combination therapy of thermal ablation,microwave ablation,in situ radiotherapy,and other therapies,greatly expanding the therapeutic strategies available for HCC treatment.Here,the current exploration of nanotechnology in TACE of HCC is briefly summarized and the challenges of TACE with nanoformulations for clinical translation are comprehensively discussed.
