Transcatheter arterial embolization therapy in unresectable hepatomas

龍作, 山田; 春樹, 中塚; 健治, 中村; 守男, 佐藤; 紅一, 玉岡; 和正, 竹本; 和夫, 水口; 真司, 山口; 正男, 玉木; 丈之, 門奈; 祐夫, 山本

doi:10.2957/kanzo.20.595

Cited by 25 publications

(5 citation statements)

References 10 publications

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“…Transcatheter arterial embolization (TAE) or lipiodolized transcatheter arterial infusion without embolization (L-TAI) is performed through the feeding artery of the HCC, since as its size increases the HCC is usually supplied with an arterial blood flow [7,14]. However, there can be adverse reactions and complications, the most distressing of which are nausea and vomiting induced by anticancer agents [3].…”

Section: Introductionmentioning

confidence: 99%

Nausea and vomiting induced by arterial chemo-embolization in patients with hepatocellular carcinoma and the antiemetic effect of ondansetron hydrochloride

Sohara

Takagi

Abe

et al. 1999

Supportive Care in Cancer

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To determine the incidence of nausea and vomiting and the antiemetic effect of ondansetron hydrochloride (OND) in patients with hepatocellular carcinoma treated with arterial chemo-embolization, we studied 59 patients with hepatocellular carcinoma who were treated with transcatheter arterial embolization (TAE) or lipiodolized transcatheter arterial infusion (L-TAI). We investigated the incidence of nausea and vomiting and the amount of food intake when TAE or L-TAI was performed. All patients who experienced nausea and vomiting received OND administered prophylactically at the time of the next TAE or L-TAI to evaluate the antiemetic effect of the drug. Cumulative rates of nausea and vomiting during the week following arterial chemo-embolization were 44.8% and 27.6%, respectively. There was a tendency for the incidence to be higher in patients treated with the anticancer agent zinostatin stimalamer (SMANCS) than in those treated with epirubicin hydrochloride (EPI). Regarding food intake, 53.1% of the patients stated that they ate "half or more than half" of the food provided on the day of arterial chemo-embolization. The rate improved as time went on. In 5 patients who experienced nausea and vomiting at the time of arterial chemo-embolization, nausea and vomiting were inhibited satisfactorily by OND. When arterial chemo-embolization was performed, antiemetic treatment for approximately 3 days was necessary to improve patients' quality of life (QOL) to an acceptable level, and OND was found to be effective for the purpose in our 5 patients who had experienced nausea and/or vomiting at the previous treatment.

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Section: Introductionmentioning

confidence: 99%

Nausea and vomiting induced by arterial chemo-embolization in patients with hepatocellular carcinoma and the antiemetic effect of ondansetron hydrochloride

Sohara

Takagi

Abe

et al. 1999

Supportive Care in Cancer

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“…Alternatively, an attempt may be made to administer other 5-FU related agents including S-1 and capecitabine. From the viewpoint of the inhibition of angiogenesis due to VEGF, it is reasonable to administer UFT at three days after TACE because the gelatin sponge dissolves and disappears within a few weeks (33,34) and it has been reported that the VEGF level increases at 7-14 days after TACE (10,35). Meticulous attention to adverse events is essential when employing chemotherapy, even as an adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant chemotherapy with tegafur/uracil administration after transcatheter arterial chemoembolization for advanced hepatocellular carcinoma

Ueda¹,

Tanaka²,

Kida³

et al. 2008

Oncol Rep

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Abstract. Although transcatheter arterial chemoembolization (TACE) is considered to be an effective treatment for advanced hepatocellular carcinoma (HCC), it is difficult to achieve complete necrosis by TACE alone due to incomplete embolization and tumor angiogenesis. Recent studies have shown that tegafur/uracil (UFT ® ) inhibits tumor angiogenesis in several cancer types. Therefore, this study was conducted to test the efficacy and toxicity of the UFT administration after TACE in advanced HCC. Thirty patients with HCC who had been treated with TACE alone more than three times and had a recurrence within 6 months were enrolled. All of the patients were treated with TACE and 28 patients were randomly assigned to the UFT (UFT 300 mg/day, three days after TACE, n=14) and control groups (n=14). The primary end point was the time to treatment failure (TTF) and the secondary end points were mainly the response rate and toxicity. Administration and observation were continued up to 6 months after TACE unless local recurrence was detected or serious adverse events developed. The median TTF in the control group was 87 days, whereas in the UFT group it was 127 days, thus significantly prolonged as compared to the control group (P=0.0016). Moreover, the overall response rate (35.7%) in the UFT group was significantly higher than that in the control group (0%). As for toxicity, only 4 patients in the UFT group developed grade 1-2 toxicities such as ascites. Serious complications by TACE were not observed in either group. Notably, there were no increases in the serum VEGF levels in the UFT group whereas those in the control group increased significantly. In conclusion, UFT administration after TACE was an effective treatment and showed no severe adverse events. This regimen may have an adjuvant role and antiangiogenic function in advanced HCC.

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“…The research of an ideal temporary embolic agent, like gelatine sponge embolization (cTACE), has a long history, beginning more than 40 years ago. Degradable Starch Microspheres (DSMs) were initially studied in animal models in Scandinavia [11] in the late 1970s. In Japan, Yamada et al introduced the transarterial treatment of HCC with an emulsion of chemotherapeutic agent and lipiodol followed by cTACE [12] .…”

Section: Rationale For Degradable Starch Microspheres Usementioning

confidence: 99%

Chemoembolization with Degradable Starch Microspheres (DSM-TACE): expanding indications in HCC multidisciplinary tumor board

Rozzanigo,

Gatti,

Luppi

et al. 2023

Hepatoma Res

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The role of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) management has changed over the last twenty years. There has been a trend towards an overall decline in TACE procedures, but with a more aggressive approach, repeating multiple TACE sessions in case of tumor response. The survival of treated patients was prolonged because of better patient selection and advancements in TACE techniques aimed at preserving liver function. At present, TACE is approved by the International Guidelines also outside of the BCLC intermediate stage after evaluation of a multidisciplinary tumor board (MDTB), permitting a customized treatment for every patient. An alternative therapeutic strategy is represented by hepatic chemoembolization with Degradable Starch Microspheres (DSM-TACE), which is based on the chemotherapeutic effect rather than on the ischemic damage to the liver tumor, requiring multiple cycles of treatment. The higher safety profile of DSM-TACE has broadened the indications to patients waiting for liver transplantation (with bridging or downstaging intention), at high risk of liver failure and ineligible for systemic therapies. This review summarises the scientific publications supporting the use of DSM-TACE and illustrates its indications depending on the disease stage from the Interventional Radiologist’s perspective.

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Transcatheter arterial embolization therapy in unresectable hepatomas

Cited by 25 publications

References 10 publications

Nausea and vomiting induced by arterial chemo-embolization in patients with hepatocellular carcinoma and the antiemetic effect of ondansetron hydrochloride

Nausea and vomiting induced by arterial chemo-embolization in patients with hepatocellular carcinoma and the antiemetic effect of ondansetron hydrochloride

Adjuvant chemotherapy with tegafur/uracil administration after transcatheter arterial chemoembolization for advanced hepatocellular carcinoma

Chemoembolization with Degradable Starch Microspheres (DSM-TACE): expanding indications in HCC multidisciplinary tumor board

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