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Objective To evaluate the effect of Babaodan capsules combined with transcatheter arterial chemoembolization (TACE) therapy in patients with BCLC stage B primary hepatocellular carcinoma (HCC). Methods A total of 32 patients with BCLC B primary hepatocellular carcinoma who cannot be treated with operation in the Department of Oncology in Fujian Province Cancer Hospital from May 2010 to March 2013 were enrolled in the experimental group. According to paired design, 64 patients with BCLC B primary liver cancer who were treated with only TACE were as control. The patients of experimental group were treated with Babaodan capsules combined with TACE, and the patients of control group were treated with only TACE. Overall response rate (ORR), time to progression (TTP), overall survival (OS), liver function change 1 week after TACE, and post-embolization syndromes were analyzed. Measurement data were compared using t test, count data were compared with χ2test. Kaplan-Meier method was used for survival analysis, and Log-rank method for testing. Results The ORR 1.5 month after TACE was 75.0%in experimental group and 81.3%in control group(P=0.477). The median TTP was 8.9 months(95%CI 3.1-14.7 months) in experimental group, and 5.5 months (95%CI 4.3-6.7 months) in control group (P=0.048). The median OS time was 16 months(95%CI 8.0-24.0 months) in experimental group, and 12 months(95%CI 11.0-13.0 months) in control group (P=0.159). Compared with the experimental group, the alanine transaminase 1 week after TACE in control group increased obviously (P=0.018). The incidence rate of ≥CTCAE grade 2 pain after the first time TACE in experimental group was lower than that in control group(P=0.019). Conclusion Babaodan capsules could reduce pain of HCC patients after TACE, improve liver damage after TACE,and prolong the TTP of patients with BCLC stage B HCC.
ABSTRACT
Objective To evaluate the effect of Babaodan capsules combined with transcatheter arterial chemoembolization (TACE) therapy in patients with BCLC stage B primary hepatocellular carcinoma (HCC). Methods A total of 32 patients with BCLC B primary hepatocellular carcinoma who cannot be treated with operation in the Department of Oncology in Fujian Province Cancer Hospital from May 2010 to March 2013 were enrolled in the experimental group. According to paired design, 64 patients with BCLC B primary liver cancer who were treated with only TACE were as control. The patients of experimental group were treated with Babaodan capsules combined with TACE, and the patients of control group were treated with only TACE. Overall response rate (ORR), time to progression (TTP), overall survival (OS), liver function change 1 week after TACE, and post-embolization syndromes were analyzed. Measurement data were compared using t test, count data were compared with χ2test. Kaplan-Meier method was used for survival analysis, and Log-rank method for testing. Results The ORR 1.5 month after TACE was 75.0%in experimental group and 81.3%in control group(P=0.477). The median TTP was 8.9 months(95%CI 3.1-14.7 months) in experimental group, and 5.5 months (95%CI 4.3-6.7 months) in control group (P=0.048). The median OS time was 16 months(95%CI 8.0-24.0 months) in experimental group, and 12 months(95%CI 11.0-13.0 months) in control group (P=0.159). Compared with the experimental group, the alanine transaminase 1 week after TACE in control group increased obviously (P=0.018). The incidence rate of ≥CTCAE grade 2 pain after the first time TACE in experimental group was lower than that in control group(P=0.019). Conclusion Babaodan capsules could reduce pain of HCC patients after TACE, improve liver damage after TACE,and prolong the TTP of patients with BCLC stage B HCC.
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Objective To investigate the safety , feasibility , and clinical application value of digital sub-traction angiography ( DSA) -guided insertion of totally implantable venous access port ( TIVAP) in patients with digestive system cancer .Methods We retrospectively analyzed the data of 15 digestive system cancer patients who were inserted with TIVAP under DSA guidance between April 2013 and January 2016, recorded the TIVAP-related complications and indwelling time, and investigated the patients’satisfaction about TIVAP.Paired rank sum test was used for the differences in patients’quality of life before and after the insertion of TIVAP.Results Of the 15 digestive system cancer patients , operation success rate of TIVAP insertion was 100%, with the success rate of venipuncture on first attempt being 100%.The incidence of complication was 6.67% ( 1/15 ) , which was manifested as pull feeling at the neck occurring in the eighth month after insertion .The indwelling time of TIVAP was from 2 to 28 months, with a median value of 9 months.Patients’satisfaction rate of TIVAP was 86.67%(13/15).The proportion of patients with a good quality of life was 100%(15/15), statically signifi-cantly higher than that before the insertion [46.67%(7/15), Z=-3.416, P=0.000).Conclusions TIVAP insertion under DSA guidance in digestive system cancer patients is safe and feasible , with few complications and fair patient satisfaction .It may improve the patient ’s quality of life , worthy of clinical application .
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Objective To compare the concordance among RECIST, EASL and modified RECIST criteria for the evaluation of tumor response after transarterial chemoembolization of primary liver cancer.Methods Fifty patients with primary liver cancer underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline, at 4 weeks after TACE procedure, and 2 independent radiologists evaluated tumor response according to above-mentioned three different criteria. Chisquare test was used to compare the response rate, and kappa coefficients were used to evaluate the coherence. Results When tumor responses were evaluated using the RECIST-EASL and modified RECIST criteria, the numbers of the patients achieved complete response, partial response, stable disease,progressive disease were 0, 10, 30, 10; 6,21,14,9; 6,21,13,10 respectively. The objective response rates for three different criteria were 20%, 54%, 54% respectively ( P ＜ 0. 01 ). Kappa coefficients between RECIST and EASL, between RECIST and modified RECIST, between EASL and modified RECIST were 0. 382, 0. 170, and 0. 857 (P = 0. 000). Conclusions RECIST criteria underestimates the extent of tumor response after TACE in primary liver cancer. Both EASL and modified RECIST criteria appear to agree with each other in determining treatment response. Furthermore, the modified RECIST is more convenient in clinical practice compared with EASL criteria.
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Objective To screen serum biomarkers in patients with hepatocelhlar carcinoma by using surface-enhanced laser desorption and ionization time-of-flight mass spectrometry(SELDI-TOF-MS)technique and to evaluate its clinical implication in the patients whose alpha-fetoprotein were negative in the sera. Methods Proteomic spectra were generated by mass spectroscopy in 112 cases, including 57 cases AFP-negative hepatocellular carcinoma,and 55 cases of healthy control. The consequence was analyzed and the characteristic preteomic peaks was selected by using Biomarker Wizard. Results Seven low expressed potential biomarker were indentified with the mass-to-charge ratio of 4.2×103, 4.1×103, 6.7×103, 5.7×103, 6.5×103, 6.9×103, 5.8×103. The sensitivity for diagnosing hepatic cancer were 88.23 % and specificity was 92.31%. These peaks were not correlated with age, sex, tumor mass size, pathology grading and cirrhosis in hepatocellular carcinoma. Conclusion SELDI-TOF-MS offers a unique platform for the proteomic detection of hepatocellular carcinoma.It also offers an auxiliary diagnosis method to the patients whose alpha-fetoprotein are negative in the serum.