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Transarterial radioembolization for hepatocellularcarcinoma: An update and perspectives 预览
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作者 Rodolfo Sacco, Valeria Mismas, Sara Marceglia, Antonio Romano, Luca Giacomelli, Marco Bertini, Graziana Federici, Salvatore Metrangolo, Giuseppe Parisi, Emanuele Tumino, Giampaolo Bresci, Ambra Corti, Manuel Tredici, Michele Piccinno, Luigi Giorgi, Carlo Bartolozzi,Irene Bargellini 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2015年第21期6518-6525,共8页
In the last decade trans-arterial radioembolization hasgiven promising results in the treatment of patientswith intermediate or advanced stage hepatocellularcarcinoma (HCC), both in terms of disease controland toler... In the last decade trans-arterial radioembolization hasgiven promising results in the treatment of patientswith intermediate or advanced stage hepatocellularcarcinoma (HCC), both in terms of disease controland tolerability profile. This technique consists of theselective intra-arterial administration of microspheresloaded with a radioactive compound (usually Yttrium90),and exerts its therapeutic effect through the radiationcarried by these microspheres. A careful and meticulousselection of patients is crucial before performingthe radioembolization to correctly perform the procedureand reduce the incidence of complications.Radioembolization is a technically complex andexpensive technique, which has only recently enteredclinical practice and is supported by scant results fromphase Ⅲ clinical trials. Nevertheless, it may representa valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCCpatients, as shown by a comparative retrospectiveassessment that reported a longer time to progression,but not of overall survival, and a more favorable safetyprofile for radioembolization. In addition, this treatmenthas reported a higher percentage of tumor shrinkage,if compared to TACE, for pre-transplant downsizingand it represents a promising therapeutic option inpatients with large extent of disease and insufficientresidual liver volume who are not immediately eligiblefor surgery. Radioembolization might also be a suitablecompanion to sorafenib in advanced HCC or it canbe used as a potential alternative to this treatmentin patients who are not responding or do not toleratesorafenib. 展开更多
关键词 Hepatocellular carcinoma RADIOEMBOLIZATION Transarterial CHEMOEMBOLIZATION SORAFENIB STAGING RECIST Modified RECIST DOWNSIZING Clinical trial
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Assessment of clinical and radiological response tosorafenib in hepatocellular carcinoma patients 预览 被引量:1
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作者 Rodolfo Sacco Valeria Mismas Antonio Romano Marco Bertini Michele Bertoni Graziana Federici SalvatoreMetrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Luca Giacomelli, Sara Marceglia, IreneBargellini 《世界肝病学杂志:英文版(电子版)》 2015年第1期33-39,共7页
Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma (HCC). The assessment oftumor progression in patients treated with sorafenibis crucial to help identify potentially-resistant patients,... Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma (HCC). The assessment oftumor progression in patients treated with sorafenibis crucial to help identify potentially-resistant patients,avoiding unnecessary toxicities. Traditional methodsto assess tumor progression are based on variationsin tumor size and provide unreliable results in patientstreated with sorafenib. New methods to assess tumorprogression such as the modified Response EvaluationCriteria in Solid Tumors or European Association forthe Study of Liver criteria are based on imaging tomeasure the vascularization and tumor volume (viableor necrotic). These however fail especially when thetumor response results in irregular development ofnecrotic tissue. Newer assessment techniques focus onthe evaluation of tumor volume, density or perfusion.Perfusion computed tomography and Dynamic Contrast-Enhanced-UltraSound can measure the vascularizationof HCC lesions and help predict tumor response to antiangiogenictherapies. Mean Transit Time is a possiblepredictive biomarker to measure tumor response.Volumetric techniques are reliable, reproducible andtime-efficient and can help measure minimal changesin viable tumor or necrotic tissue, allowing the promptidentification of non-responders. Volume ratio may be areproducible biomarker for tumor response. Larger trialsare needed to confirm the use of these techniques in theprediction of response to sorafenib. 展开更多
关键词 Hepatocellular carcinoma SORAFENIB ResponseEvaluation Criteria in Solid TUMORS Perfusioncomputed tomography Dynamic Contrast-Enhanced-UltraSound VOLUMETRIC ASSESSMENT
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