DOI QR코드

DOI QR Code

Three Treatment Methods via the Hepatic Artery for Hepatocellular Carcinoma - A Retrospective Study

  • Ma, Teng-Chuang (Department of Radiology, The First Hospital, China Medical University) ;
  • Shao, Hai-Bo (Department of Radiology, The First Hospital, China Medical University) ;
  • Xu, Yang (Department of Radiology, The First Hospital, China Medical University) ;
  • Xu, Ke (Department of Radiology, The First Hospital, China Medical University)
  • Published : 2013.04.30

Abstract

Background: To evaluate the relative effectiveness of different treatments of hepatocellular carcinoma (HCC) via the hepatic artery. Materials and Methods: The study sample group consisted of 418 patients who were randomly selected from 2008 to 2012 with a first diagnosis of HCC and treated with transcatheter arterial chemoembolization (TACE) or without (TAE) chemotherapy or transcatheter arterial infusion (TAI). We collected data including tumor size preoperative and one month thereafter to compare change in areas across the three groups, along with various laboratory indexes for comparison. Results: The overall average change of areas was $240.8{\pm}72.1mm^2$. In the three groups it was $265.0{\pm}58.0mm^2$ vs. $250.5{\pm}51.9mm^2$ vs. $123.7{\pm}26.2mm^2$. In groups TACE and TAE values were larger than in group TAI (p<0.01), but the difference between the two was not statistically significant (p= 0.191). Additionally, U/L change of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in groups TACE and TAE was greater than in the TAI cases ($24.0{\pm}13.5$ vs. $20.9{\pm}12.1$ vs. $5.47{\pm}8.20$ and $25.6{\pm}13.5$ vs.$23.2{\pm}12.28$ vs.$5.48{\pm}14.3$) on the preoperative day and two days thereafter (p<0.01). Between the two groups there was no significant cariation (p= 0.320 and p= 0.609). However, the AST and ALT recovered to normal levels one month later on therapy with liver protecting drugs. Conclusion: The groups TACE and TAE demonstrated more effective reduction of tumor size than group TAI. While lipiodol caused acute liver function damage, this proved reversible.

Keywords

References

  1. Bruix J, Sherman M, Llovet JM, et al (2001). Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. Hepatol J, 35, 421-30. https://doi.org/10.1016/S0168-8278(01)00130-1
  2. Camma C, Schepis F, Orlando A, et al (2002). Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology J, 224, 47-54. https://doi.org/10.1148/radiol.2241011262
  3. Farinati F, Giacomin A, Vanin V, et al (2012). TACE treatment in hepatocellular carcinoma: what should we do now. Hepatol J, 57, 221-2. https://doi.org/10.1016/j.jhep.2011.12.022
  4. Forner A, Llovet JM, Bruix J (2012). Chemoembolization for intermediate HCC: is there proof of survival benefit. Hepatol J, 56, 984-6. https://doi.org/10.1016/j.jhep.2011.08.017
  5. Geschwind JF, Ramsey DE, Choti MA, et al (1988). Chemoembolization of hepatocellular carcinoma: results of a metaanalysis. Clin Oncol AM J, 26, 344-9.
  6. Ikoma A, Kawai N, Sato M, et al (2012). Comparison of blood dynamics of anticancer drugs (cisplatin, mitomycin C, epirubicin) in treatment groups of hepatic arterial infusion, hepatic arterial infusion with lipiodol and transcatheter arterial chemoembolization with lipiodol plus gelatin sponge particles in a swine model. Hepatol Res J, 42, 1227-35. https://doi.org/10.1111/j.1872-034X.2012.01040.x
  7. Izumi R, Urade M, Kimura H, et al (1988). Combined hepatic arterial infusion chemotherapy with transcatheter arterial embolization and hyperthermia in primary liver cancer. Gan To Kagaku Ryoho, 15, 2465-9.
  8. Lencioni R (2012). Chemoembolization for hepatocellular carcinoma. Semin Oncol J, 39, 503-9. https://doi.org/10.1053/j.seminoncol.2012.05.004
  9. Llovet JM, Bruix J (2003). Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology J, 37, 429-42. https://doi.org/10.1053/jhep.2003.50047
  10. Marelli L, Stigliano R, Triantos C, et al (2007). Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol J, 30, 6-25. https://doi.org/10.1007/s00270-006-0062-3
  11. Miraglia R, Pietrosi G, Maruzzelli L, et al (2007). Efficacy of transcatheter emoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma. World J Gastroenterol J, 13, 2952-5.
  12. Morse MA, Hanks BA, Suhocki P, et al (2012). Improved time to progression for transarterial chemoembolization compared with transarterial embolization for patients with unresectable hepatocellular carcinoma. Clin Colorectal Cancer J, 11, 185-90. https://doi.org/10.1016/j.clcc.2011.11.003
  13. Oliveri RS, Wetterslev J, Gluud C (2011). Transarterial (chemo) embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev, 16, CD004787.
  14. Pleguezuelo M, Marelli L, Misseri M, et al (2008). TACE versus TAE as therapy for hepatocellular carcinoma. Expert Rev Anticancer Ther, 8, 1623-41. https://doi.org/10.1586/14737140.8.10.1623
  15. Takayama W, Asano T, Kobayashi S, et al (1998). Hepatic arterial infusion chemotherapy (HAI) for advanced hepatocellular carcinoma inefficacious with transcatheter arterial embolization (TAE). Gan To Kagaku Ryoho, 25, 867-71.

Cited by

  1. I Seed Implantation for Treatment of Primary Hepatocellular Carcinoma vol.15, pp.13, 2014, https://doi.org/10.7314/APJCP.2014.15.13.5155
  2. Prognostic Significance of the Peripheral Blood Absolute Monocyte Count in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma Receiving Systemic Chemotherapy vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6387
  3. Safety and Efficacy of Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization prior to Major Hepatectomy for Patients with HCC vol.15, pp.2, 2014, https://doi.org/10.7314/APJCP.2014.15.2.703
  4. Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2681
  5. Prognostic factors of spontaneously ruptured hepatocellular carcinoma vol.21, pp.24, 2015, https://doi.org/10.3748/wjg.v21.i24.7488
  6. Transarterial Therapies for Hepatocellular Carcinoma: a Comprehensive Review with Current Updates and Future Directions vol.17, pp.2, 2016, https://doi.org/10.7314/APJCP.2016.17.2.473