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Objective To investigate the application of C- arm CT imaging technique in evaluating the efficacy of transarterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). Methods During the period from Sep. 2012 to Mar. 2013 at authors’ hospital, C- arm CT scanning was employed during the performance of TACE in 80 patients with HCC. The residual active tumor lesions, Lipiodol deposition and the embolization of the feeding arteries after TACE therapy were assessed by C- arm CT plain scan images and the images of early artery phase and parenchymal phase, as well as the post- processing images. The efficacy of TACE was thus evaluated. Results A total of 139 hepatic tumors were detected in 80 patients by C- arm CT imaging. C- arm CT scanning performed immediately after TACE showed that satisfactory result was obtained in 128 lesions of 75 patients(128/139, 92.9%). Fewer, medium and more residual active tumors were seen in 78, 29 and 21 lesions respectively, while dense, moderate and thin Lipiodol deposition was seen in 64, 39 and 25 lesions respectively. After TACE therapy obvious decrease in blood supply was demonstrated in 101 lesions, while no obvious decrease in blood supply was seen in 27 lesions. Conclusion C- arm CT scanning after TACE for patients with HCC can conveniently, accurately and comprehensively reveal the residual active tumors, Lipiodol deposition and embolization status of feeding arteries. Therefore, this technique should be regarded as an important means to evaluate the efficacy of TACE.
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Objective To investigate the clinical efficacy of transarterial chemoembolization (TACE) combined with sorafenib for the treatment of inoperable hepatocellular carcinoma (HCC), and to discuss the influence of treatment interval on the survival time. Methods During the period from July 2008 to May 2011 at authors’ hospital, a total of 50 patients with inoperable HCC were treated with TACE together with sorafenib. The treatment intervals between each TACE procedure were recorded. The results were analyzed. Results Up to Dec. 31, 2011, the median follow-up time of the 50 patients was 310 days. The mean interval between TACE treatments was 69 days before the combination treatment was employed , while the mean interval was 112 days after the combination treatment started , and the longest interval was 648 days. Conclusion Combination treatment TACE with sorafenib can remarkably prolong the treatment interval in patients with inoperable HCC, thus the patient can get more survival benefits.
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Objective To evaluate the value of the mRECIST criteria in assessing the efficacy of transcatheter arterial chemoembolization(TACE) combined with sorafenib in the treatment of hepatocellular carcinoma (HCC).Methods A total of 35 patients who were treated with a combination of TACE and sorafenib for unresectable hepatocellular carcinoma fulfilled the mRECIST and RECIST criteria in our hospital from June 2011 to November 2012.Enhanced CT and/or enhanced MRI were used before (baseline) and after (3 month reexamination) combination treatment in our hospital.The mRECIST and RECIST criteria were used to evaluate the efficacy,and these efficacy assessments were compared.Results In the RECIST criteria,complete remission (CR) was 0％,partial remission (PR) was 2.9％,stable disease (SD) was 85.7％％,and progressive disease (PD) was 11.4％％.In the mRECIST criteria,CR was 8.6％,PR was 51.4％,SD was 34.3％,and PD was 5.7％.For the RECIST criteria,the objective response rate (CR+-PR) was 2.9％,the disease control rate (CR+PR+SD) was 88.6％,and the disease progression rate was 11.4％.For the mRECIST criteria,the objective criteria was 60％,the disease control rate was 94.3％,and the disease progression rate was 5.7 ％.The difference between the efficacy assessment results of mRECIST and RECIST was statisti cally significant(P＜0.001).Conclusion The mRECIST criteria can evaluate the efficacy of target le sions based on viable tumors,which is more adaptive to TACE and targeted drugs with new mecha nisms.
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Objective To investigate the charateristics and prognostic value of computed tomography (CT) of retropharyngeal lymphadenopathy (RLN) in nasopharyngeal carcinoma (NPC).Methods From 1991 to 2006, CT images were analyzed for 588 patients with histologically proven NPC treated with radiation therapy in our hospital.The survival rate was evaluated by Kaplan-Meier method.Results RLN metastases were presented in 392 patients, with unilateral side in 254 patients and bilateral sides in 138 patients.The 5-year distant metastasis-free survival (DMFS) rate of patients with and without RLN metastasis was 66.6% and78.6%(χ2 = 10.78,P=0.005) ,with 69.7% and 62.2%(χ2 =2.31,P=0.129) for patients with unilateral and bilateral sides involvement.The DMFS rate was similar between the mild and moderate enhancement of RLN (67.6% and 58.9% ,χ2=2.77,P =0.096).The survival rate of RLN with homogeneous density was better than heterogeneous density (71.5%, 53.3% and 32.5%,respectively, χ2= 10.51, P = 0.001, χ2= 24.28, P = 0.000).The survival rate of patients with well boarded RLN was better than those with ill boarded RLN and obviously adjacent tissue involvement (65.5%, 51.8%and 50.0% , χ2 =8.20,P=0.004, χ2 =5.31 ,P=0.021).Conclusions The prognosis is poor with RLN metastasis, lymph node enhancement, heterogeneous density in nodes and ill boarded RLN.