ABSTRACT
Purpose@#The aim of this study was to compare the effectiveness and outcomes of percutaneous ablation guided by ultrasonography (US) and computed tomography (CT) in colorectal liver oligometastases (CLOM). @*Methods@#This study included patients with CLOM treated with percutaneous ablation from January 2008 to January 2021 in this observational study. Only lesions visualized on both CT and US images were further analyzed according to whether patients’ initial ablation treatments utilized US guidance or CT guidance. The Kaplan-Meier method was used to estimate local tumor progression (LTP)–free survival after propensity score matching (PSM). The LTP-free survival and treatment-related outcomes were compared between these two groups. @*Results@#PSM identified 116 patients from each group, with 269 and 238 lesions in the USguided and CT-guided groups, respectively. US-guided ablation had a shorter average procedure time and lower cost than CT-guided ablation (27.54±12.06 minutes vs. 32.70±13.88 minutes, P=0.003; $2,175.13±618.17 vs. $2,455.49±710.25, P=0.002). For patients >60 years of age, the cumulative LTP rate at 1 year was lower in the US-guided group than in the CT-guided group (17.8% vs. 25.1%, P=0.038). For patients with perivascular liver lesions, the cumulative LTP rate at 1 year was lower in the US-guided group (14.4% vs. 28.2%, P=0.040). @*Conclusion@#For patients whose age is >60 years or who have perivascular liver lesions, USguided ablation is better than CT-guided ablation, with a shorter treatment time and lower costs when both ablation methods are feasible for patients.
ABSTRACT
Acute myeloid leukaemia (AML) is the most common form of acute leukaemia in adults, with increasing incidence with age and a generally poor prognosis. Almost 20% of AML patients express mutant isocitrate dehydrogenase 2 (mIDH2), which leads to the accumulation of the carcinogenic metabolite 2-hydroxyglutarate (2-HG), resulting in poor prognosis. Thus, global institutions have been working to develop mIDH2 inhibitors. SH1573 is a novel mIDH2 inhibitor that we independently designed and synthesised. We have conducted a comprehensive study on its pharmacodynamics, pharmacokinetics and safety. First, SH1573 exhibited a strong selective inhibition of mIDH2 R140Q protein, which could effectively reduce the production of 2-HG in cell lines, serum and tumors of an animal model. It could also promote the differentiation of mutant AML cell lines and granulocytes in PDX models. Then, it was confirmed that SH1573 possessed characteristics of high bioavailability, good metabolic stability and wide tissue distribution. Finally, toxicological data showed that SH1573 had no effects on the respiratory system, cardiovascular system and nervous system, and was genetically safe. This research successfully promoted the approval of SH1573 for clinical trials (CTR20200247). All experiments demonstrated that, as a potential drug against mIDH2 R140Q acute myeloid leukaemia, SH1573 was effective and safe.
ABSTRACT
Tumor microenvironment has been widely utilized for advanced drug delivery in recent years, among which hypoxia-responsive drug delivery systems have become the research hotspot. Although hypoxia-responsive micelles or polymersomes have been successfully developed, a type of hypoxia-degradable nanogel has rarely been reported and the advantages of hypoxia-degradable nanogel over other kinds of degradable nanogels in tumor drug delivery remain unclear. Herein, we reported the synthesis of a novel hypoxia-responsive crosslinker and the fabrication of a hypoxia-degradable zwitterionic poly(phosphorylcholine)-based (
ABSTRACT
Objective Serum miRNA has been regarded as a potential biomarker for diagnosis, therapeutic evaluation and prognostic prediction in cancer patients. This study aims to explore the clinical significance of the expression level of metastasis- related microRNA (miR- 18b) in the serum in AFP- negative (≤ 20 ng/ml) hepatocellular carcinoma(HCC) patients receiving radiofrequency ablation (RFA). Methods A total of 131 HCC patients with negative serum AFP, who were encountered during the period from January 2007 to January 2011 at authors’ hospital, were enrolled in this study. Radiofrequency ablation (RFA) of the lesions was carried out in all patients. Serum samples were collected before RFA. Forty - three healthy individuals were selected for control. The expression level of serum miR - 18b was deternmined by using quantitative real- time PCR method in all the patients and the healthy individuals. The correlations of the expression level of serum miR - 18b with clinico - pathological factors, postoperative recurrence, overall cirrhosis (P = 0.035), tumor diameter (P < 0.01) and tumor differentiation (P = 0.020). During the follow-up period, 79 patients (60.3%) developed recurrent tumors, and the expression level of serum miR- 18b in them was dramatically higher than that in the patients showing no recurrence (3.26 ± 1.28 vs. 2.42 ± 0.86, P <0.01). The incidence of recurrence after RFA, especially distant intrahepatic metastasis, in patients with higher expression level of serum miR- 18b was strikingly higher than that in patients with lower expression level of serum miR- 18b (72.3% vs. 48.5%, P = 0.005). Kaplan- Meier survival analysis indicated that both overall survival rate and recurrence- free survival rate of patients with higher expression level of serum miR-18b were significantly lower than those of patients with lower expression level of serum miR- 18b. Conclusion The expression level of serum miR - 18b is significantly elevated in AFP - negative HCC patients. The expression level of serum miR- 18b might be used as an ideal biomarker for monitoring tumor recurrence as well as for predicting prognosis after RFA.
ABSTRACT
Objective To evaluate the treatment effect and security of transcatheter arterial chemoembolization(TACE)combined with sorafinib for intermediate-advanced hepatocellular carcinoma.Methods From July 2008 to November 2010,the treatment effects of two groups of patients with advanced hepatocellular carcinoma were retrospectively analyzed and compared,including 44 patients treated by sorafenib combined with TACE(test group)and the other 44 patients treated only with TACE(control group).To assess the treatment effect based on mRECIST,the time for patients' tumor progression(TTP),overall survival(OS)time and adverse events were recorded.Survival rate were analyzed using KaplanMeier method and Log-rank analysis in SPSS 18.0.Results Till January 2011,24 patients(54.5％)survived and 20 patients(include patients lost to visit)died(45.5％)among the test group,13 patients survived(29.5 ％)and 31 patients(include patients lost to visit)died(70.5 ％)among the control group.No complete remission condition was observed in all patients.Among the test group,1 patient got partial remission,24 ones remain stable and 19 patients got progression.While among the control group,conditions remained stable in 21 patients and progressed in rest 23 ones.The disease control rate(DCR)in the test group and control group were 56.8％(25/44)and 47.7％(21/44)respectively,with no statistical significance(x2 =0.729,P =0.393).The median overall survival time(mOS)of test group and control group were 21.0(95 ％ CI:14.9-27.1)months and 10.0(95 ％ CI:6.4-13.6)months respectively,and the difference reached statistical significance(x2 =7.436,P =0.006).The median time to tumor progression(mTTP)of test group and control group was 1 1.0(95％ CI:8.7-13.3)and 6.0(95％ CI:3.9-8.1)months respectively,and the difference had statistical significance(x2 =10.437,P =0.001).The adverse events of test group mainly included hand-foot skin reaction,loss of appetite,fever,fatigue and diarrhea.The adverse events of control group mainly included fever,loss of appetite,nausea,vomiting and fatigue.The incidences of hand-foot skin reaction,baldness,diarrhea were significantly higher in test group than those in the control group(P ＜0.05).In most patients,these side effects were mild-to-moderate,and alleviated remarkablely after symptomatic treatment.Conclusions Compared with TACE alone,TACE combined with sorafenib can prolong the OS and TTP significantly for the patients with intermediate-advanced hepatocellular carcinoma.However,the DCR of the two groups has no statistical significance.
ABSTRACT
Objective To investigate the interventional therapy for the complication in the treatment of advanced primary hepatocellular carcinoma.Methods 62 cases of primary hepatocellular carcinoma confirmed by pathology,imagings and AFP,were randomly divided into 2 groups according to odd or even hospitalization number.32 patients were enrolled in the TACE group(control group)and 30 patients were enrolled in the combination therapy group(TACE + other kinds of therapy).Patients in the combination therapy group underwent the TACE procedure adding with another kind of therapy for treating the complication such as arterial,venous,portal vein cancer embolism,or the inferior vena cava tumor embolisms and may further include ablation of residual cancer,jaundice,hepatic abscess or biloma.Results 1,2,3-years survival rates and median survival rates of the control group and combination therapy group were 68%,50%,19% and 87%,75%,48%;1.5 years and 2 years,respectively.Survival rate and duration in the combination therapy group was significantly greater than those of control group(P
ABSTRACT
Objective To investigate the effectiveness of TACE in combination with percutaneous microwave coagulation therapy(PMCT) in treatment of hepatocellular carcinoma.Methods 82 cases of hepatocellular carcinoma confirmed by pathology were randomly divided into 2 groups by odd or even hospitalization number.A total of 40 patients were enrolled in the TACE only group(group A) and 42 patients were enrolled in the synthetic therapy group(group B,underwent treatment by TACE in combination with PMCT).Results The survival rates in 1,2 and 3 years were 70%,54% and 20%,respectively,with a median survival of 1.72 years in group A,and 88%,76% and 51%,respectively,with a median survival of 2.1 years in group B.The survival rates in group B were significantly higher than that in group A(P
ABSTRACT
Objective To investigate the therapeutic methods and curative effect of combined interven-tional therapy on hepatic metastasis from colorectal cancer. Methods Hepatic artery angiography and port-calheter-system( PCS) were undertaken in 35 cases of liver metastasis from colorectal cancers. Therapeutic measare were divided into transcatheter arterial infusion(TAl) in 10 cases and transcatheter arterial emboliza-tion(TAE) in 25 cases according to their angiographic features. Drugs included oxalic acid platinum, CPT11 , MMC and 5-Fu + CF. Laser ablation under the CT guidance was taken after 2-3 courses of treatment, including 9 cases of ethanol ablation besides laser ablation. The curative effects were determined after laser ablation by checking with CT and CEA one month later. Results The lesions shrank in 17 cases, while 13 remained the same and enlarged in other 5 after 2-3 courses of TAE or TAI. CEA reduced in 6 cases, with no change in other 5 and increas in another 3 among the 14 positive CEA cases. CT scan showed spotty gasification in 29 cases and whole gasification in 6 after additional ablation treatment. Among them, the foci dwindled in 8 cases treated by solely laser ablation, with no change in 5 and increase in 7. The foci dwindled in 5 cases, 2 remainal the same and increase in 2 of 9 cases treated by the combination of laser ablation and percutaneous ethanol injection (PEI). Among 8 unchanged or increased CEA cases after TAE or TAI, showed decrease in 3 cases, other 4 remained the same and another increased after ablation. Conclusions 1. The blood supply of hepatic metastastic foci from coloreclal cancer is mainly fed by hepatic artery and subselective transcatheter angiography showed tumor stain clearly. 2. By means of PCS and TAI or TAE, using oxalic acid platinum, CPT11 and 5-Fu regular chemical therapy provided a better curative effect for metastasis. But 3. TAI or TAE can not eliminate all foci laser combining with ethanol ablation would be the effective complement.