TACE

Tace
  • 文章类型: Journal Article
    这项研究的目的是报告通过肝内动脉联合经动脉放射栓塞(TARE)和通过肝外供血动脉(EHFA)联合经动脉化疗栓塞(TACE)的安全性和肿瘤反应率肝细胞癌(HCC)。
    肝癌患者,在介入前多相CT上可见肝内和肝外动脉供应,并在2016年至2021年之间对同一结节进行TACE和TARE联合治疗,被回顾性地包括在内。流行病学,临床,生物,并记录了放射学特征。在6个月时评估安全性和肿瘤反应。
    9名患者(8名男性,中位年龄62岁[IQR:54-72岁])。7名患者先前对目标结节进行过治疗(TARE:5;TACE:2)。病变的中长轴(LA)为70mm(IQR:60-79mm)。3例患者有门静脉侵犯(VP3)。EHFA起源于右膈动脉(n=6),右肾上腺动脉(n=2),胃左动脉(n=1)。用TACE处理的肿瘤部分的LA为47mm(范围:35-64mm)。整个病变的LA与用TACE治疗的LA之间的比率为1.44(范围:1.27-1.7)。发生了一种主要并发症:慢性急性肝衰竭。中位随访时间为23个月(范围:16-29个月)。7例患者接受了进一步治疗:在同一病变上(n=2),在新出现的结节(n=2)上,和全身治疗(n=3)。在6个月的随访中,7例患者表现出局部客观反应.进展时间为13(3.5-19)个月。
    TARE和肝外TACE联合治疗肝癌,肝内和肝外动脉供应似乎是可行和安全的。需要进一步的研究来验证这些初步结果的有效性。
    UNASSIGNED: The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC).
    UNASSIGNED: Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded. Safety and tumor response were assessed at 6 months.
    UNASSIGNED: Nine patients (8 men, median age 62 years [IQR: 54-72 years]) were included. Seven patients had previous treatments on the target nodule (TARE: 5; TACE: 2). The median longest axis (LA) of the lesion was 70 mm (IQR: 60-79 mm). Three patients had portal vein invasion (VP3). The EHFA originated from the right diaphragmatic artery (n = 6), the right adrenal artery (n = 2), and the left gastric artery (n = 1). The LA of the tumor portion treated with TACE was 47 mm (range: 35-64 mm). The ratio between the LA of the entire lesion and the LA treated with TACE was 1.44 (range: 1.27-1.7). One major complication occurred: acute on chronic liver failure. Median follow-up was 23 months (range: 16-29 months). Seven patients underwent further treatment: on the same lesion (n = 2), on newly appeared nodules (n = 2), and systemic treatment (n = 3). At 6-month follow-up, seven patients showed a local objective response. Time-to-progression was 13 (3.5-19) months.
    UNASSIGNED: The combination of TARE and extrahepatic TACE for HCC with both intrahepatic and extrahepatic arterial supplies seems feasible and safe. Further studies are needed to validate the effectiveness of these preliminary results.
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  • 文章类型: Case Reports
    在这个案例报告中,我们介绍了一例46岁的肝神经内分泌肿瘤(NETG2)诱导的肝转移女性。最初,进行了肝左外叶切除术.术后病理检查显示NETG2,导致术后恢复。Further,肝脏磁共振成像(MRI)复查显示左外侧叶肿瘤术后改变,肝脏多发肿块和可能的转移。因此,肝脏介入治疗和基于阿帕替尼的靶向治疗基于“卡利珠单抗+阿帕替尼”方案进行,分别。随访20个月,肝门及腹膜后淋巴结稍多,伴有手足综合征。最终,整体情况继续缓解,表明联合治疗可以显着改善NETG2病症相关的肝转移。
    In this case report, we present the case of a 46-year-old woman with a hepatic neuroendocrine tumor (NET G2)-induced liver metastases. Initially, the left lateral lobectomy of the liver was performed. The post-operative pathological examination revealed NET G2, leading to the post-operative recovery with a general review. Further, the re-examination of liver magnetic resonance imaging (MRI) showed post-operative changes in the tumor of the left lateral lobe, with multiple liver masses and possible metastasis. Thus, the liver interventional therapy and apatinib-based targeted therapy based on the \"camrelizumab + apatinib\" regimen were performed, respectively. The 20-month follow-up indicated a slightly increased hepatic hilum and retroperitoneal lymph nodes, accompanied by hand-foot syndrome. Eventually, the overall condition continued to relieve, indicating that the combined treatment could substantially improve the NET G2 conditions-associated liver metastasis.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    肝细胞癌合并门静脉癌栓预后差,中位生存期仅为3-6个月。PD-1联合靶向治疗可能为BCLCC期肝细胞癌合并门静脉癌栓患者提供根治性手术的机会。显著延长其生存时间。
    2020年5月在我中心诊断为肝细胞癌合并门静脉主干癌栓的一名51岁中年男性,BCLC分期为C,肝硬化,HBV感染,术前评估为不可切除。肝功能Child-PughA。最初的治疗是lenvatinib联合PD-1治疗,随后进行一个周期的TACE治疗。肿瘤和血栓体积明显缩小,持续TACE联合免疫治疗和靶向治疗,导致门静脉主干栓子的出现。经过多学科的讨论,进行了手术切除,栓子被移除,实现治愈。患者已超过34个月无肿瘤。
    PD-1联合lenvatinib和局部TACE为根治性手术创造条件,希望更多的真实研究数据能够为肝细胞癌合并门静脉癌栓的转化治疗提供更好的证据。
    UNASSIGNED: The prognosis of hepatocellular carcinoma combined with portal vein tumor thrombus is poor, with a median survival of only 3-6 months. PD-1 combined with targeted therapy may provide an opportunity for patients with BCLC C stage hepatocellular carcinoma combined with portal vein tumor thrombus to undergo radical surgery, significantly prolonging their survival time.
    UNASSIGNED: A middle-aged 51-year-old male who was diagnosed with hepatocellular carcinoma combined with portal vein main stem tumor thrombus at our center in May 2020, with a BCLC stage of C, liver cirrhosis, HBV infection, and preoperative evaluation as unresectable. The liver function was Child-Pugh A. The initial treatment was lenvatinib combined with PD-1 therapy, followed by one cycle of TACE treatment. The tumor and thrombus volume significantly reduced, followed by continuous TACE combined with immunotherapy and targeted therapy, leading to the appearance of portal vein main stem emboli. After multidisciplinary discussion, surgical resection was performed, and the embolus was removed, achieving a cure. The patient has been tumor-free for over 34 months.
    UNASSIGNED: PD-1 combined with lenvatinib and local TACE create conditions for radical surgery, and it is hoped that more real-world research data can provide better evidence for the transformational treatment of hepatocellular carcinoma combined with portal vein tumor thrombus.
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  • 文章类型: Case Reports
    lenvatinib(LEN)加经动脉化疗栓塞(TACE)后的手术治疗是中期肝细胞癌(HCC)的有用治疗选择。一名有丙型肝炎病史的66岁男子在尾状叶和肝脏6/7段检测到四个肿块,计算机断层扫描显示最大病变直径为14厘米。患者被诊断为中期HCC,并接受LEN+TACE治疗。恢复LEN8周后,计算机断层扫描显示肿瘤的染色区域变弱,也没有新的病变.因此,在改良的实体瘤疗效评估标准中,患者被评估为部分缓解.病人接受了肝尾状叶切除术,S6/7肝部分切除术和S6微波凝固治疗根治性切除术。患者目前存活且术后12个月无复发。在患有多发性HCC病变的患者中,肝切除联合局部治疗可能是一种有效的治疗选择。
    Surgical therapy following lenvatinib (LEN) plus transarterial chemoembolization (TACE) is a useful therapeutic option for intermediate-stage hepatocellular carcinoma (HCC). A 66-year-old man with a history of hepatitis C was detected four masses in the caudate lobe and segment 6/7 of the liver, with a maximum lesion diameter of 14 cm by computed tomography. The patient was diagnosed with intermediate-stage HCC and received LEN plus TACE. After resuming LEN for 8 weeks, computed tomography showed weakened stained areas of the tumors, and no new lesions. Thus, the patient was evaluated as having a partial response in the modified Response Evaluation Criteria in Solid Tumors. The patient underwent hepatic caudate lobectomy, partial hepatectomy of S6/7, and S6 microwave coagulation therapy for radical resection. The patient is currently alive and recurrence-free at 12 months postoperatively. In patients with multiple HCC lesions, hepatic resection combined with local therapy might be an effective treatment option.
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  • 背景:一名43岁女性患者被发现肝功能异常,常规筛查中异常升高的甲胎蛋白和肝脏占位性病变。患者来我院进一步诊治。
    方法:调查:实验室调查,肝动脉数字减影血管造影(DSA),腹部超声检查,采用病理染色和免疫组织化学进行磁共振成像(MRI)扫描。
    方法:临床诊断:cT3NxM0。巴塞罗那临床肝癌(BCLC)分期:BCLC分期C.中国肝癌(CNLC)分期:CNLCⅢa.
    结论:患者首次接受肝动脉化疗栓塞(TACE)和基于FOLFOX的肝动脉灌注化疗(HAIC)。然后,根据FOLFOX对第二次和第三次住院患者进行HAIC治疗.在前三种治疗中,卡姆雷珠单抗和溶瘤病毒也通过微导管注射到肝癌中。在第四次录取时,患者的指标有所改善,肿瘤缩小了.此外,由于患者最初几次出现不良反应,我们暂停了FOLFOX和溶瘤病毒的治疗.手术治疗前,在整个治疗过程中都使用了乐伐替尼。在第五次入场时,患者接受了肝癌切除术。
    结论:它证明了多种联合治疗的价值,可以为无法手术切除的晚期肝细胞癌患者提供指导。
    A 43-year-old female patient was found to have an abnormal liver function, abnormally elevated alpha-fetoprotein and space-occupying lesions in the liver on routine screening. The patient came to our hospital for further diagnosis and treatment.
    Investigations: Laboratory investigations, digital subtraction angiography (DSA) of the hepatic artery, abdominal ultrasound examination, and magnetic resonance imaging (MRI) scan were conducted using pathological staining and immunohistochemistry.
    Clinical diagnosis: cT3NxM0. Barcelona clinic liver cancer (BCLC) staging: BCLC stage C. China liver cancer (CNLC) staging: CNLC IIIa.
    The patient was hospitalized for the first time for transcatheter arterial chemoembolization (TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (HAIC). Then, the second and third hospital admissions were given HAIC based on FOLFOX. Camrelizumab and oncolytic virus were also injected into the liver cancer through the microcatheter in the first three treatments. On the fourth admission, the patient\'s indicators were improved, and the tumor shrank. Furthermore, as the patient suffered adverse reactions the first few times, we suspended the treatment of FOLFOX and the oncolytic virus. Before surgical treatment, lenvatinib was used throughout the treatment. On the fifth admission, the patient underwent liver cancer resection.
    It proves the value of multiple combination therapy, which can provide guidance for patients with advanced hepatocellular carcinoma that cannot be surgically removed.
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  • 文章类型: Case Reports
    肾上腺皮质癌(ACC)是一种罕见的,异质,和侵袭性恶性肿瘤,预后一般较差。手术切除是最优的医治计划。手术后,米托坦治疗或依托泊苷-多柔比星-顺铂(EDP)方案加米托坦化疗都有一定的效果,但是复发和转移的可能性仍然非常高。肝脏是最常见的转移靶点之一。因此,可在特定组患者中尝试肝肿瘤的经导管动脉化疗栓塞(TACE)和微波消融(MWA)等技术.我们介绍了一名44岁女性原发性ACC患者的病例,切除后6年被诊断为肝转移。在米托坦治疗期间,我们根据患者的临床情况进行了4个疗程的TACE和2个MWA手术.患者保持部分反应状态,目前已恢复正常生活。此案例说明了米托坦加TACE和MWA治疗的实际应用价值。
    Adrenocortical carcinoma (ACC) is a rare, heterogeneous, and aggressive malignancy with a generally poor prognosis. Surgical resection is the optimal treatment plan. After surgery, both mitotane treatment or the etoposide-doxorubicin-cisplatin (EDP) protocol plus mitotane chemotherapy have a certain effect, but there is still an extremely high possibility of recurrence and metastasis. The liver is one of the most common metastatic targets. Therefore, techniques such as transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) for liver tumors can be attempted in a specific group of patients. We present the case of a 44-year-old female patient with primary ACC, who was diagnosed with liver metastasis 6 years after resection. During mitotane treatment, we performed four courses of TACE and two MWA procedures in accordance with her clinical condition. The patient has maintained the partial response status and has currently returned to normal life to date. This case illustrates the value of the practical application of mitotane plus TACE and MWA treatment.
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  • 文章类型: Case Reports
    肝上皮样血管平滑肌脂肪瘤(HEAML)是一种罕见的间充质组织肿瘤,具有恶性倾向。最常见于女性,男性和女性的相对发病率,据不完全统计,大约是1:5。在极少数情况下,疾病的发生和发展是隐蔽的。病变通常是患者偶然发现的;腹痛是首发症状,影像学在诊断疾病方面没有特异性。因此,HEAML的诊断和治疗存在很大困难。这里,一名51岁女性患者有乙型肝炎病史,8个月以上的腹痛是最初的症状,被描述。患者被发现患有多发性肝内血管平滑肌脂肪瘤。由于病灶小而分散,完全切除是不可能的,因为她的乙肝病史,进行保守治疗,患者接受定期随访。当不能排除肝细胞癌时,患者接受经导管动脉化疗栓塞治疗.在1年的随访中未检测到肿瘤新生或转移。
    Hepatic epithelioid angiomyolipoma (HEAML) is a rare tumour of mesenchymal tissue with a malignant tendency. Occurring most frequently in women, the relative incidence in men and women, according to incomplete statistics, is approximately 1:5. In rare cases, disease occurrence and development is hidden. Lesions are generally discovered as chance findings by patients; abdominal pain is the first symptom, and imaging has no specificity in diagnosing the disease. Therefore, great difficulties exist in the diagnosis and treatment of HEAML. Here, the case of a 51-year-old female patient with a history of hepatitis B, and abdominal pain over 8 months as the initial symptom, is described. The patient was found to have multiple intrahepatic angiomyolipoma. Due to the small and scattered foci, complete resection was impossible, and because of her history of hepatitis B, conservative treatment was undertaken, with the patient undergoing regular follow-up. When hepatic cell carcinoma could not be excluded, the patient was treated with transcatheter arterial chemoembolization. No tumour neogenesis or metastasis was detected at the 1-year follow-up.
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  • 文章类型: Case Reports
    UNASSIGNED:在肝细胞癌(HCC)中,由I期相关肝分区和门静脉结扎进行分期肝切除术(ALPPS)引起的未来肝残留(FLR)可能由于肝纤维化/肝硬化或肝实质横断不全而受到限制。
    未经证实:一名51岁男性乙型肝炎肝纤维化患者被诊断为大型肝癌(13.5cm×12.5cm×13.8cm)。患者的FLR不足以允许一期肿瘤切除。因此,计划进行两阶段ALPPS手术.第一阶段ALPPS由于出血而进行了不完全的肝实质横切(这就是为什么我们称之为Mini-ALPPS)。术后第18天(POD),CT显示FLR肥大较差。FLR/标准肝脏体积(SLV)仅从22.00%增加到34.63%。对POD进行了22天的挽救性经肝动脉化疗栓塞(TACE),以控制等待期间可能的肿瘤进展并进一步促进FLR生长。大约16天后,CT对FLR的重新评估显示有42.5%的FLR/SLV。然后顺利地进行了右肝切除术。虽然肝癌在586天后复发,患者在II期ALPPS后存活超过1,920天.
    UNASSIGNED:在困难的常规阶段IALPPS中进行损伤控制很重要。在这种Mini-ALPPS的间期和术后期间TACE是安全和有益的。基于Mini-ALPPS的多学科治疗可以为患者提供长期生存;然而,目前不应选择Mini-ALPPS作为此类患者的主要解决方案,因为其他一些微创和有效的策略是可用的。
    UNASSIGNED: The future liver remnant (FLR) induced by stage I associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma (HCC) might be limited due to liver fibrosis/cirrhosis or incomplete liver parenchymal transection.
    UNASSIGNED: A 51-year-old male with hepatitis B liver fibrosis was diagnosed with a large HCC (13.5 cm × 12.5 cm × 13.8 cm). The FLR of the patient was insufficient to permit one-stage tumor resection. Therefore, the two-stage ALPPS surgery was planned. Stage I ALPPS was performed with incomplete liver parenchymal transection due to bleeding (which is why we called it Mini-ALPPS). On postoperative day (POD) 18, CT revealed that the FLR hypertrophy was poor. The FLR/standard liver volume (SLV) had only increased from 22.00% to 34.63%. Salvage transhepatic arterial chemoembolization (TACE) was performed on POD 22 days to control possible tumor progression during the waiting period and to further facilitate FLR growth. About 16 days later, a CT reassessment of FLR revealed a 42.5% FLR/SLV. A right hepatectomy was then uneventfully performed. Although HCC recurred after 586 days, the patient survived for more than 1,920 days after stage II ALPPS.
    UNASSIGNED: Damage control during a difficult conventional stage I ALPPS was important. TACE during the interstage and postoperative periods of this Mini-ALPPS was safe and beneficial. A multidisciplinary based on Mini-ALPPS treatment could provide patients long-term survival; however, Mini-ALPPS should not be selected as the primary solution for such patients today, as some other minimally invasive and effective strategies are available.
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  • 文章类型: Case Reports
    该病例是一名67岁女性,患有常染色体显性多囊肾病,并定期随访。CT扫描显示,在过去的4年中,在被肝囊肿包围的低密度区域内有一个壁结节。手术治疗,病理诊断为I期胆囊癌。
    The case is a 67-year-old female with autosomal dominant polycystic kidney disease who was followed up regularly. CT scan showed a mural nodule growing over the past 4 years inside the hypodense region surrounded by hepatic cysts. Surgery was performed and the pathological diagnosis was StageI gallbladder cancer.
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