Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Comparative Study on Transcatheter Arterial Chemoembolization, Portal Vein Embolization and High Intensity Focused Ultrasound Sequential Therapy for Patients

  • Cui, Lin (Department of Chemotherapy, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research) ;
  • Liu, Xing-Xiang (Department of Oncology, Jiangyan People Hospital, the Affiliated Hospital of Yangzhou University) ;
  • Jiang, Yong (Department of Chemotherapy, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research) ;
  • Wu, Xing-Jun (Department of Oncology, Jiangyan People Hospital, the Affiliated Hospital of Yangzhou University) ;
  • Liu, Jian-Jun (Department of Oncology, Jiangyan People Hospital, the Affiliated Hospital of Yangzhou University) ;
  • Zhou, Xiang-Rong (Department of Chemotherapy, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research) ;
  • He, Xue-Jun (Department of Chemotherapy, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research) ;
  • Huang, Xin-En (Department of Chemotherapy, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research)
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE), combined with portal vein embolization (PVE), and high intensity focused ultrasound (HIFU) sequential therapy in treating patients with hepatocellular carcinoma (HCC). Methods: Patients with inoperative HCC were treated by two methods: in the study group with TACE first, then PVE a week later, and then TACE+PVE every two months as a cycle, after 2~3 cycles finally HIFU was given; in the control group only TACE+PVE was given. Response (CR+PR), and disease control rate (CR+PR+SD), side effects, overall survival and time to progress were calculated. Results: Main side effects of both groups were nausea and vomiting. No treatment related death occurred. In the study group, 32 patients received TACE for overall 67 times, PVE 64 times, and HIFU 99 times; on average 2.1, 2 and 3.1 times for each patient, respectively. In the control group, 36 patients were given TACE 78 times and PVE 74 times, averaging 2.2 and 2.1 times per patient. Effective rate: 25.0% in study group and 8.3% in control group (p>0.05). Disease control rates were 71.9% and 44.4%, respectively (p<0.05). In patients with portal vein tumor thrombus, the rate reduced over 1/2 after treatment was 69.2%(9/13) in the study and 21.4%(3/14) in the control group (p<0.05). Rate of AFP reversion or decrease over 1/2 was 66.7%(16/24) in study and 37%(10/27) (p<0.05) in control group. Median survival time: 16 months in study and 10 months in control group. PFS was 7months in study and 3 months in control group. Log-rank test suggested that statistically significant difference exists between two groups (p=0.024). 1-, 2- and 3-year survival rates were 56.3%, 18.8% and 9.3% in study, while 30.6%, 5.6% and 0 in control group, respectively, with statistically significant difference between two groups (by Log-rank, p = 0.014). Conclusions: The treatment of TACE+PVE+HIFU sequential therapy for HCC increases response rate, prolong survival, and could thus be a safe and effective treatment for advanced cases.

Keywords

References

  1. Bridges JF, Joy SM, Gallego G, et al (2011). Needs for hepatocellular carcinoma control policy in the Asia-Pacific region. Asian Pac J Cancer Prev, 12, 2585-91.
  2. Cheung TT, Chu FS, Jenkins CR, et al (2012).Tolerance of high-intensity focused ultrasound ablation in patients with hepatocellular carcinoma. World J Surg, 36, 2420-7. https://doi.org/10.1007/s00268-012-1660-7
  3. Cui L, Zhang ZS, Yu YQ, et al (2004). Treatment of primary hepatic carcinoma with double embolization and chemotherapy via hepatic artery and portal vein. Chin Clinical Oncol, 9, 404-5.
  4. Gao LL, Huang XE, Zhang Q, et al (2011). A Cisplatin and vinorelbine (NP) regimen as a postoperative adjuvant chemotherapy for completely resected breast cancers in China: final results of a phase II clinical trial. Asian Pac J Cancer Prev, 12, 77-80.
  5. Gong P, Huang XE, Chen CY, et al (2012). Comparison on complications of peripherally inserted central catheters by ultrasound guide or conventional method in cancer patients. Asian Pac J Cancer Prev, 13, 1873-5. https://doi.org/10.7314/APJCP.2012.13.5.1873
  6. Huang XE, Li CG, Li Y, et al (2011). Weekly TP regimen as a postoperative adjuvant chemotherapy for completely resected breast cancer in China: final result of a phase II trial. Asian Pac J Cancer Prev, 12, 2797-800.
  7. Hua H, Qin S, Rui J, Li J (2011). Pharmacokinetics of arsenic trioxide $(As_2O_3)$ in Chinese primary hepatocarcinoma patients. Asian Pac J Cancer Prev, 12, 61-5.
  8. Jiang Y, Huang XE, Yan PW, et al (2010). Validation of treatment efficacy of a computer-assisted program for breast cancer patients receiving postoperative adjuvant chemotherapy. Asian Pac J Cancer Prev, 11, 1059-62.
  9. Jin CB, Wu F, Wang ZB, et al (2003). High intensity focused ultrasound therapy combined with transcatheter arterial chemoembolization for advanced hepatocellular carcinoma. Chin J Oncol, 25, 401-3.
  10. Kamsa-ard S, Wiangnon S, Suwanrungruang K, et al (2011). Trends in liver cancer incidence between 1985 and 2009, Khon Kaen, Thailand: cholangiocarcinoma. Asian Pac J Cancer Prev, 12, 2209-13.
  11. Kim J, Chung DJ, Jung SE, et al (2012). Therapeutic effect of high-intensity focused ultrasound combined with transarterial chemoemb olisation for hepatocellular carcinoma smaller than 5 cm: comparison with transarterial chemoembolisation monotherapy--preliminary observations. Br J Radiol, 5, 293-9.
  12. Li CG, Huang XE, Xu L, et al (2012). Clinical application of serum tumor associated material (TAM) from non-small cell lung cancer patients. Asian Pac J Cancer Prev, 13, 301-4. https://doi.org/10.7314/APJCP.2012.13.1.301
  13. Li CG, Huang XE, Li Y, et al (2011). Phase II trial of irinotecan plus nedaplatin (INP) in treating patients with extensive stage small cell lung cancer. Asian Pac J Cancer Prev, 12, 487-90.
  14. Li CG, Huang XE, Li Y, et al (2011). Clinical observations on safety and efficacy of $OxyContin^{(R)}$ administered by rectal route in treating cancer related pain. Asian Pac J Cancer Prev, 12, 2477-8.
  15. Li Y, Yan PW, Huang XE, et al (2011). MDR1 gene C3435T polymorphism is associated with clinical outcomes in gastric cancer patients treated with postoperative adjuvant chemotherapy. Asian Pac J Cancer Prev, 12, 2405-9.
  16. Liu W, Li SY, Huang XE, et al (2012). Inhibition of tumor growth in vitro by a combination of extracts from Rosa roxburghii Tratt and Fagopyrum cymosum. Asian Pac J Cancer Prev, 13, 2409-14. https://doi.org/10.7314/APJCP.2012.13.5.2409
  17. Lu JZ, Ji KX, Yu YQ, et al (1986). Observation of the blood supply of human hepatocellular carcinoma. Tumor, 6, 183-8.
  18. Okusaka T, Odada S, Ueno H, et al (2000). Evaluation of the therapeutic effect of transcatheter arterial embolization for hepatocellular carcinoma. Oncology, 58, 293-9. https://doi.org/10.1159/000012115
  19. O'Neill BE, Karmonik C, Li KC (2010). An optimum method for pulsed high intensity focused ultrasound treatment of large volumes using the InSightec $ExAblate^{(R)}$ 2000 system. Phys Med Biol, 55, 6395-410. https://doi.org/10.1088/0031-9155/55/21/004
  20. Parkin DM, Bray F, Ferlay J, et al (2005). Globle cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  21. Pan WN, Mao SM, Li RX, et al (2001). Treatment of unresectable primary hepatic carcinoma with embolization and chemotherapy via hepatic artery and portal vein. J Hepatobiliary Sury, 9, 445-7.
  22. Schwarz RE, Smith DD (2008). Trends in local therapy for hepatocellular carcinoma and survival outcomes in the US population. Am J Surg, 195, 829-36. https://doi.org/10.1016/j.amjsurg.2007.10.010
  23. Siperstein AE, Barber E (2001). Cryoablation percutaneous alcohol injection and radiofrequency ablation for treatment of neuroendocrine liver metastases. World J Sury, 25, 693-6. https://doi.org/10.1007/s00268-001-0015-6
  24. Society of Liver Cancer CACA (2000). The diagnosing standards for hepatocellular carcinoma. Chin J Hepatol, 8, 135.
  25. Shu J, Li CG, Liu YC, et al (2012). Comparison of serum tumor associated material (TAM) with conventional biomarkers in cancer patients. Asian Pac J Cancer Prev, 13, 2399-403. https://doi.org/10.7314/APJCP.2012.13.5.2399
  26. Xu JW, Li CG, Huang XE, et al (2011). Ubenimex capsule improves general performance and chemotherapy related toxicity in advanced gastric cancer cases. Asian Pac J Cancer Prev, 12, 985-7.
  27. Xu HX, Huang XE, Li Y, et al (2011). A clinical study on safety and efficacy of Aidi injection combined with chemotherapy. Asian Pac J Cancer Prev, 12, 2233-6.
  28. Xu HX, Huang XE, Qian ZY, et al (2011). Clinical observation of $Endostar^{(R)}$ combined with chemotherapy in advanced colorectal cancer patients. Asian Pac J Cancer Prev, 12, 3087-90.
  29. Xu T, Xu ZC, Zou Q, Yu B, Huang XE (2012). P53 Arg72Pro polymorphism and bladder cancer risk - meta- analysis evidence for a link in asians but not caucasians. Asian Pac J Cancer Prev, 13, 2349-54. https://doi.org/10.7314/APJCP.2012.13.5.2349
  30. Yan PW, Huang XE, Jiang Y, et al (2010). A clinical comparison on safety and efficacy of Paclitaxel/Epirubicin (NE) with Fluorouracil/Epirubicin/Cyclophosphamide (FEC) as postoperative adjuvant chemotherapy in breast cancer. Asian Pac J Cancer Prev, 11, 1115-8.
  31. Yan PW, Huang XE, Yan F, et al (2011). Influence of MDR1 gene codon 3435 polymorphisms on outcome of platinum-based chemotherapy for advanced non small cell lung cancer. Asian Pac J Cancer Prev, 12, 2291-4.
  32. Yu DS, Huang XE, Zhou JN, et al (2012). A Comparative Study on the Value of Anal Preserving Surgery for Aged People with Low Rectal Carcinoma in Jiangsu, China. Asian Pac J Cancer Prev, 13, 2339-40. https://doi.org/10.7314/APJCP.2012.13.5.2339
  33. Yu ZJ, Meng XY, Chen JP, et al (1996). Clinical observations on the sequencial TACE, TSAI, and PVE treatment in advanced hepatocellular carcinoma with portal vein tumor thrombius. Chin J Dig, 16, 32-5.
  34. Zhang L, Zhu H, Jin C, et al (2009). High-intensity focused ultrasound (HIFU): effective and safe therapy for hepatocellular carcinoma adjacent to major hepatic veins. Eur Radiol, 19, 437-45. https://doi.org/10.1007/s00330-008-1137-0
  35. Zhang LQ, Huang XE, Wang J (2011). The cyclin D1 G870A polymorphism and colorectal cancer susceptibility: a metaanalysis of 20 populations. Asian Pac J Cancer Prev, 12, 81-5.
  36. Zhang XZ, Huang XE, Xu YL, et al (2012). Phase II study on voriconazole for treatment of Chinese patients with malignant hematological disorders and invasive aspergillosis. Asian Pac J Cancer Prev, 13, 2415-8. https://doi.org/10.7314/APJCP.2012.13.5.2415
  37. Zhou GX, Chen JP, Huang JF, et al (1998). Clinical observations on the sequencial TAE, PVE, and PEI treatment in advanced hepatocellular carcinoma. Chin J Oncol, 20, 312.
  38. Zhou JN, Huang XE, Ye Z, et al (2009). Weekly paclitaxel/ Docetaxel combined with a paltinum in the treatment of advanced non-samll cell lung cancer: a study on efficacy, safety and pre-medication. Asian Pac J Cancer Prev, 10, 1147-50.
  39. Zhou Q, Wang Y, Zhou X, et al (2011). Prognostic analysis for treatment modalities in hepatocellular carcinomas with portal vein tumor thrombi. Asian Pac J Cancer Prev, 12, 2847-50.

Cited by

  1. Application of Lobaplatin in Trans-catheter Arterial Chemoembolization for Primary Hepatic Carcinoma vol.15, pp.2, 2014, https://doi.org/10.7314/APJCP.2014.15.2.647
  2. 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
  3. Lobaplatin Combined Floxuridine/Pirarubicin-based Transcatheter Hepatic Arterial Chemoembolization for Unresectable Primary Hepatocellular Carcinoma vol.15, pp.5, 2014, https://doi.org/10.7314/APJCP.2014.15.5.2057
  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