The Evolving Role of Local Treatments for HCC in the Third Millennium

Magistri, Paolo; Tarantino, Giuseppe; Ballarin, Roberto; Berretta, Massimiliano; Pecchi, Annarita; Ramacciato, Giovanni; Benedetto, Fabrizio Di

doi:10.21873/anticanres.11331

Cited by 13 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…lesions. In agreement with the previous findings after RFA in HCC [24], tumor size seems to represent a basic parameter that impacts technique effectiveness in ICC. In two studies, Carrafiello [25] and Kim [26] suggested that RFA may provide local control in patients with tumors smaller than about 3.5 cm; in the first study Carrafiello et al, in particular, reported a technique effectiveness of 66%.…”

Section: Discussionsupporting

confidence: 91%

Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Brandi

Rizzo

Dall’Olio

et al. 2020

International Journal of Hyperthermia

View full text Add to dashboard Cite

Background & aims: Very few data are available in literature about the role of radiofrequency ablation (RFA) in intrahepatic cholangiocarcinoma (ICC) and previous studies are mainly case reports and case series on a very small number of patients and nodules. In this study, we aimed to evaluate effectiveness and safety of RFA for the treatment of unresectable ICC. Methods: This is a retrospective observational cohort study comprising all consecutive patients treated with RFA for unresectable ICC at Policlinico Sant'Orsola Malpighi Hospital, Bologna, Italy. Primary endpoint was Local Tumor Progression-Free Survival (LTPFS) while Overall Survival (OS) was also assessed as secondary endpoint. Results: From January 2014 to June 2019, 29 patients with 117 nodules underwent RFA. Technique effectiveness 1 month after RFA was 92.3%; median LTPFS was 9.27 months. Univariate analysis and multivariate analysis showed that LTPFS was significantly related to tumor size 20 mm. At a median follow up of 39.9 months, median OS from the date of RFA was 27.5 months, with an OS of 89%, 45% and 11% at 1, 2 and 4 years, respectively. Number of overall lesions and the sum of their diameter at the moment of the first RFA significantly affected OS in multivariate analysis. Minor and major complication rates were 14% and 7%, respectively. Conclusion: Tumor size 20 mm was associated with lower LTPFS, representing a potential useful threshold value. A careful evaluation of tumor burden appears as a crucial element in choosing the best therapeutic strategy in unresectable ICC.

show abstract

Section: Discussionsupporting

confidence: 91%

Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Brandi

Rizzo

Dall’Olio

et al. 2020

International Journal of Hyperthermia

View full text Add to dashboard Cite

show abstract

“…Bland embolization (i.e., embolization with microparticles that do not carry a drug) is now commonly used in gynecology to achieve uterine artery embolization 2‐4 (leading to shrinkage of uterine fibroids [benign tumors growing the the wall of the uterus]). TACE is currently applied in oncology, particularly to treat patients with hepatocellular carcinoma (the most common form of primary liver cancer) in the intermediate stage 5‐13 …”

Section: Introductionmentioning

confidence: 99%

“…TACE is currently applied in oncology, particularly to treat patients with hepatocellular carcinoma (the most common form of primary liver cancer) in the intermediate stage. [5][6][7][8][9][10][11][12][13] During the last 10-15 years, we witnessed the development and clinical introduction of so-called drug-eluting beads (DEBs) to be used in TACE. 14 These are embolic polymer microspheres loaded with a chemotherapeutic agent, such as doxorubicin, irinotecan, idarubicin, and sunitinib.…”

Section: Introductionmentioning

confidence: 99%

Polymer microparticles with a cavity designed for transarterial chemo‐embolization with crystalline drug formulations

et al. 2020

View full text Add to dashboard Cite

Transarterial chemo‐embolization with drug‐eluting embolic beads (DEB‐TACE) is still evolving. Recent developments include the introduction of radiopaque (X‐ray imageable) drug‐eluting particles. Here, we report on conceptually different radiopaque polymeric drug‐eluting embolic particles, which are (i), cross‐linked poly(methacrylates); (ii), radiopaque; (iii), microporous. Furthermore, the particles are not perfectly spherical: they have a large indentation in the sense that they are either a spherical/cup‐shaped or ellipsoid/mouth‐shaped. The micropores and the large indentation can confer useful features upon the particles, since they can be filled with a crystalline lipophilic chemotherapeutic drug. It is important, in this respect that (i), many potent chemotherapeutics are lipophilic and crystalline; (ii), available drug‐eluting beads (DEBs) have the limitation that they can only be used in combination with water‐soluble chemotherapeutic agents. Cup‐ and mouth‐shaped particles were obtained in a Cu(0) catalyzed free‐radical polymerization reaction. The microparticles could be charged with crystalline drug, in such a manner that the crystals reside in both the micropores and the large cavity, and in quantities that would be required for effective local chemotherapy. The antifungal drug voriconazole, lipophilic, and crystalline, was used to demonstrate this. We believe that the ability of the microporous/cavitated DEBs to carry lipophilic chemotherapeutic drugs is especially important. DEB‐TACE is likely to become a cornerstone method of interventional oncology in the years ahead, and the new embolic particles described herein hold the promise of becoming scope widening for the technique.

show abstract

“…TACE has now become the preferred technique for the treatment of hepatocellular carcinoma (HCC). 7,8 The newest forms of TACE in oncology use drug-eluting embolic microspheres. These particles do not only embolize part of the tumour's vascular tree, they also locally deliver a cytostatic agent (such as doxorubicin), or a low-molecular-mass multi-tyrosine kinase inhibitor such as sorafenib (also known as NexavarR) or vandetanib, in a controlled manner.9-12 Embolic microspheres are of scientific and technical interest.…”

Section: Introductionmentioning

confidence: 99%

Engineering Iodine-Containing 3D-Crosslinked Methacrylic Micro-spheres for Trans arterial Embolization. Evaluation of Fluoroscopic (X-ray) Visibility in a Hospital Setting

Koole¹

2017

IJNME

View full text Add to dashboard Cite

Transarterial chemo-embolization (TACE) provides a successful treatment mode for some benign or malignant tumors. The success of TACE is largely due to (i), development of excellent instruments and techniques for real-time X-ray imaging, and (ii), advanced catheters which allow for accurate intra-arterial navigation. Further improvements can -most probably-be achieved by enhancing the functionality of the embolic particles. For example, embolic particles can be made radiopaque, which means that they can be visualized in situ through X-ray fluoroscopy and computed tomography (CT). X-ray visibility of the radiopaque 3D-crosslinked methacrylic iodine-containing embolic microspheres of the new embolization product X-Spheres was evaluated. A rabbit cadaver model and stateof-the-art imaging equipment in a hospital setting were used. Clear visibility of the particles was found in CT images, especially if the plane of vision is chosen in such that overlap with bone structures is avoided. Therefore, the use of radiopaque embolic microspheres can provide important and otherwise inaccessible post-procedural information about the efficacy of the procedures.

show abstract

The Evolving Role of Local Treatments for HCC in the Third Millennium

Cited by 13 publications

References 46 publications

Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Polymer microparticles with a cavity designed for transarterial chemo‐embolization with crystalline drug formulations

Engineering Iodine-Containing 3D-Crosslinked Methacrylic Micro-spheres for Trans arterial Embolization. Evaluation of Fluoroscopic (X-ray) Visibility in a Hospital Setting

Contact Info

Product

Resources

About