ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of endovascular placement of iodine-125 seed strand and stent combined with transcatheter arterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with tumor thrombus in the main portal vein (MPVTT).</p><p><b>METHODS</b>Fifty patients with HCC complicated by MPVTT were enrolled into this study. There were 46 men and 4 women with a mean age of 53.9 years. TACE was performed after the iodine-125 seed strand and self-expandable stent placement in the obstructed segment of the main portal vein (MPV).</p><p><b>RESULTS</b>Technical success rate was 100% for placement of iodine-125 seed strand and stent in the target segment of MPV. No serious procedure-related complications occurred. The mean follow-up duration was 208.5 d. The mean and median survival time was 370.1 d and 223.0 d, respectively. The 90-, 180-, 360-day cumulative survival rates were 97.5%, 59.3%, and 38.4%, respectively. The mean and median patent time of stent was 524.2 d and 407.4 d, respectively. The 90-, 180-, 360-day cumulative patency rates of stent were 94.9%, 75.2%, and 64.5%, respectively.</p><p><b>CONCLUSION</b>Endovascular placement of iodine-125 seed strand and stent combined with TACE is an effective therapy for HCC with tumor thrombus in the main portal vein.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Pathology , Therapeutics , Chemoembolization, Therapeutic , Methods , Combined Modality Therapy , Follow-Up Studies , Iodine Radioisotopes , Therapeutic Uses , Liver Neoplasms , Pathology , Therapeutics , Neoplastic Cells, Circulating , Portal Vein , Pathology , Stents , Survival RateABSTRACT
Objective To evaluate the therapeutic effects of poly(N-isopropylacrylamide)adriamycin magnetic nanoparticles(ADM-PNIPAM-Fe_3O_4)on liver VX2 tumor in rabbits via transcatheter arterial chemoembolization.Methods VX2 tumor pieces were successfully implanted into liver lobes of rabbits with liver tumors formation.All the animals were randomly divided into 4 groups of 8 each.Group A(control group)injected with 10 ml physiologic saline,Group B(ADM group)treated with free adriamycin (1 mg/kg)via arterial infusion,Group C(ADM-PNIPAM group)ADM-PNIPAM(1.5 mg/kg)was infused through arterial route,Group D(ADM-PNIPAM-Fe_3O_4+M group)ADM-PNIPAM-Fe_3O_4(2 mg/kg)was infused through arterial route;all were in individual doses,respectively;meanwhile an persistant magnet with intensity of 0.4 T was stabilized at the tumor region.Spiral CT scans were performed to measure size of liver tumors and evaluate lung metastasis at 1 day before operation and 14 days after operation.All experimental animals were sacrficed on the 15th days after operation and followed by pathologic and histologic examination of the tumor and lung specimens including changes befor and after the operation with correlative comparisons.Results There were no significant difference in volumes of tumors among 4 groups at 1 day before operation.The average tumor volume in the group A was(23.87?7.02)cm~3 at 14 days after operation;(7.70?1.53)cm3 in group B;(4.29?0.25)cm~3 in group C;(2.05?0.18)cm~3 in group D. The average tumor volumes in the group B,group C and group D were significantly smaller than that in the control group A at same time after operation and there was significant difference among the three experimental groups.According to the order of tumor sizes from small to large was as follows:group D＜group C＜group B＜group A.It showed that the average size of group D(ADM-PNIPAM-Fe_3O_4+M group) was the smallest among the 4 groups.Lung metastatic rates were 100%,66.7%,37.5% and 12.5% in group A,group B,group C and group D at 14 days after operation,respectively.Lung metastatic rates of group D was lower than that of group A,but there were no significant differences among group A,B and C.But pathological examination showed that there were lesser number of lung metastatic tumors in group B and C than that of group A .The intratumoral necrotic degrees showed as group D＞group C＞group B＞group A. Conclusions ADM-PNIPAM-Fe_3O_4 treatment for liver tumor via vascular interventional method combined with magnetic field localized in the lesion possesses significant inhibitory effect on tumor growth of liver VX2 tumor in rabbits.ADM-PNIPAM-Fe_3O_4 is thus initially confirmed as a kind of effective praeputium in interventional chemoembolization.
ABSTRACT
Objective To assess the treatment effects of As_2O_3-PLGA microspheres on VX2 rabbits liver tumor models.Methods Thirty-two New Zealand white rabbits were involved with formation of VX2 rabbits liver tumor models,and randomly divided into 4 groups of 8 each.(a)As_2O_3 plus 0.9% NaCl solution group:3 F co-catheter was plugged into hepatic artery,and then As_2O_3(3 mg/kg)plus 10 ml 0.9%NaCl solution was injected into the tumor through the feeding artery;(b)As_2O_3-PLGA microspheres group :As_2O_3- PLGA microspheres(3 mg/kg)was injected into the tumor through the feeding artery;(c)PLGA mierospheres group:Injection of PLGA microspheres(3 mg/kg)injected into the tumor through the feeding artery;(d) control group:0.9% NaCl solution(10 ml)was injected into the feeding artery.Dual phase helical CT scans were performed the day before treatment,20 days after treatment and finally the rabbits were sacrificed.The sizes of the tumor were measured and followed by histopathological analysis and HE staining.Results The volumes of tumors post operatively of group a,b,c and d were(31.08?11.15)cm~3,(3.82?2.537)cm~3, (13.22?4.665)cm~3 and(115.8?62.01)cm~3 respectively.The most significant treatment effect was available in group b,with more coagulation necrosis and fibrotic tissue formation.Statistical analysis indicated that the treatment effects of group a,b,c were better than that of group d with significant difference which can be also seen between group a and b,group b and c.Conclusion As_2O_3-PLGA microspheres shows rather excellent chemoembolization effects on VX2 rabbit liver tumor model with safely.