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ObjectiveTo observe the effect of the Fangfeng Tongshengsan on post-chemoembolization syndrome with primary liver cancer or postoperative liver metastases of colorectal cancer. MethodSeventy-two patients suffered from post-chemoembolization syndrome after transcatheter hepatic arterial chemoembolization were randomly divided into 2 groups， including a Fangfeng Tongshengsan group and a control group， with 36 patients in each group. The patients in Fangfeng Tongshengsan group orally took the decoction for consecutive 7 d. The patients in the control group were physically cooled down with alcohol rub bath and ice pack for consecutive 7 d. Furthermore， the difference of fever， Karnofsky performance status （KPS）， pain in the liver region， nausea vomiting， constipation， and liver function between these two groups were observed. ResultCompared with the control group， Fangfeng Tongshengsan significantly relieved fever， reduced the body temperature （P<0.05）， and shortened the duration of fever （P<0.05）， indicating that Fangfeng Tongshengsan remarkably improved the KPS （P<0.05）. Meanwhile， Fangfeng Tongshengsan obviously alleviated nausea， vomiting， and constipation status and shortened the duration time compared with the control group （P<0.05）. In addition， the parameters of liver function including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ-glutamyl transpeptidase （GGT）， and total bilirubin （TBIL） were significantly decreased in the Fangfeng Tongshengsan group （P<0.05）， which indicated that Fangfeng Tongshengsan alleviated liver dysfunction of patients with post-chemoembolization syndrome. ConclusionFangfeng Tongshengsan can be used to treat post-chemoembolization syndrome with primary liver cancer and postoperative liver metastases of colorectal cancer.
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Objective:To establish a questionnaire to assess symptom of embolization syndrome after transcatheter hepatic arterial chemoembolization (TACE) in patients with liver cancer, so as to provide a tool of assessing and managing symptom management after TACE.Methods:From March 2020 to June 2021, through literature review, qualitative interview and Delphi expert consultation, the first draft of symptom assessment questionnaire for TACE post-operative embolism syndrome was prepared. The reliability and validity of the questionnaire were tested in 200 patients with liver cancer treated by TACE in department of Liver Oncology, Zhongshan Hospital affiliated to Fudan University.Results:According to the feedback from Delphi expert consultation a draft questionnaire with 9 items of physiological symptoms and 6 items of psychological and social symptoms was formed. Item analysis showed that each item in the questionnaire had a good degree of differentiation. There was significant correlation between each item and the total score of the questionnaire. Three factors were extracted by exploratory factor analysis, naming psychosocial symptom group as factor 1, somatic discomfort symptom group as factor 2 and gastrointestinal reaction symptom group as factor 3, and the cumulative variance contribution rate was 62.592%. Spearman correlation coefficient between this questionnaire and the Anderson Symptom Assessment Scale was 0.855( P<0.05). The Cronbach α of the total questionnaire was 0.898, and. The Cronbach α of the three factors were 0.885, 0.771 and 0.870 respectively. Conclusions:The symptom assessment questionnaire of embolization syndrome after TACE in liver cancer patients prepared in this study has good reliability and validity, which can provide an evaluation basis for the symptom management of TACE.
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Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75％ (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23％,66.65％ and 33.18％ at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.
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Objective To evaluate the efficacy and safety of 125I seed implantation combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (PHC).Methods 156 patients who had unresectable PHC seen from January 2012 to December 2015 in our unit were randomly assigned into the study group (76 patients) and the control group (80 patients).The study group of patients were treated with intra-hepatic implantation of 125I seed + TACE,and the control group of patients were treated with three dimensional conformal radiotherapy (3DCRT) + TACE.After ra diotherapy the two groups of patients underwent 2 to 3 times TACE treatment.The biomarker levels were compared between the two groups before and after treatment,and the short-term efficacy,clinical safety and 1 year survival rates were assessed.Results The success rates of the treatment for the two groups were both 100％.Patients in the study group were implanted with 1 016 125I seeds,with an average of (13.7 ± 2.5) seeds per patient.The two groups had no significant difference on short-term efficacy (P ＞ 0.05).The DCR,ORR and 1 year survival rates in the study group were 63.2％,92.1％,55.5％,and they were 61.3％,90.0％,58.1％ in the control group,respectively.There were no significant differences between these 2 groups (P ＞ 0.05).At 1 month after treatment,the two groups had no significant differences onAFP,IGF-Ⅱ and IGFBP-2 [(5.08±0.85) μg/L vs.(5.12 ±0.79) μg/L,(4.77 ±0.58) μg/L vs.(4.86 ±0.53) μg/L,(4.98 ±0.67) μg/L vs.(5.04 ±0.71) μg/L] (P＞0.05).There were no signif-icant differences on chemotherapy drug toxicities between the two groups (P ＞ 0.05).The incidence of radi-ation hepatitis in the study group was 1.3％,while the incidences of radiation dermatitis,hepatitis,gastriculcer in the control group were 5.0％,8.8％,2.5％,respectively.The radiation dermatitis incidence inthe study group was significantly lower than that of the control group (P ＜ 0.05).In the study group,2 pa-tients (2.6％) had their 125I seed slightly moved.Conclusion The short-term efficacy of 125I seed implan-tation plus TACE in the treatment of PHC is no less than the 3DCRT + TACE regimen,but with less radia-tion side effects.
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Objective To evaluate the short-term effect of elemene combined with transcatheter hepatic arterial chemoembolization (TACE) interventional therapy for the treatment of moderate and advanced liver cancer.Methods A total of 63 patients with moderate and advanced liver cancer were randomized into test group(31 cases) and control group(32 cases). Both groups were given TACE, and additionally, the test group was given intra-arterial infusion of Elemene Emulsion(400-600 mg/m2)together with MAO(Mitomycin C 4-6 mg/m2 , adriamycin 20-40 mg/m2, Oxaliplatin 50-85 mg /m2), and the control group was given intra-arterial infusion of MAO. Short-term effect was evaluated by the clinical outcomes of tumor size, progression-free survival(PFS), total survival rate and adverse reactio n. Results(1)The overall response rate(ORR) in the test group was superior to that in the control group, and the difference was statistically significant(P0.05).(3) No severe toxic or side effect was found in t he twogroups, the difference being not significant(P>0.05). The test group tended to have milder adverse reaction. Conclusion Intra-arterial infusion Elemene Emulsion combined with TACE interventional therapy is effective in increasing ORR, prolonging PFS, promoting adverse reaction endure and relieving symptoms of weakness, abdominal distension and pain.
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Objective To assess the effect of radiofrequency ablation ( RFA) combined with transcatheter hepatic arterial chemoemboli-zation ( TACE) and radiofrequency ablation alone for the treatment of early hepatocellular carcinoma ( HCC) with liver cirrhosis. Methods The data of all the patients that were given RFA+TACE (n=51) and RFA (n=53) treatments in our hospital from January 2008 to De-cember 2013 were analyzed. The demographic data,process of operation,postoperative complications,postoperative recovery and follow-up of the patients in two groups were carefully compared. Results The average follow-up time was (37. 6 ± 20. 7)months,38 cases were dead and 76 cases were survival. The overall survival rates of 1 years,3 years,5 years after operation were respectively 96. 5%,78. 7%,65. 9% in RFA+TACE group and 94. 3%,75. 6%,62. 3% in RFA group. Tumor-free survival rates of 1 years,3 years,5 years were 75. 4%,47. 3%, 32. 6% in RFA+TACE group,and 63. 1%,37. 2%,22. 4% in RFA group. Conclusion For patients with early hepatocellular carcinoma with liver cirrhosis,RFA combined with TACE have higher tumor free survival rate than RFA alone in the treatment of early hepatocellular carcinoma,but no difference in overall survival rate. The results still need to be validated by prospectively randomized controlled trials.
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Objective To investigate curative efficacy of tetramethylpyrazine in combination with chemotherapy in treatment of medium and advanced liver cancer and its effects on level of brain-derived neurotrophic factor ( BDNF).Methods 90 patients of medium and advanced liver cancer who received therapy from January 2011 to June 2012 were selected as research objects.According to therapeutic schemes, those patients were divided into the control group (n=42) and the observation group (n=48).The control group was treated with transcatheter hepatic arterial chemoembolization ( TACE) , while the observation group was treated with tetramethylpyrazine in combination with TACE.Then, the short-term curative efficacy, long-term curative efficacy, level of BDNF and adverse reactions were compared.Results The total short-term therapeutic efficacy ratio in the observation group was statistically higher than that in the control group ( 83.3% vs 64.3%, P <0.05 ).During the three-year follow-up, the one-year and two-year survival rate in the observation group was statistically same with that in the control group respectively (75.0% vs 66.7%, 66.7% vs 59.5%), while the three-year survival rate was statistically higher than that in the control group (52.1%vs 30.9%, P<0.05).After treatment, in comparison with the control group, level of BDNF in the observation group was statistically lower(P<0.05).During treatment, incidences of liver function deterioration, abdo minal pain and diarrhea, nausea and vomiting, fever and headache in two groups were statistically same.Conclusion Tetramethylpyrazine in combination with TACE is effective for medium and advanced liver cancer, which can increase short-term and survival rate to some extent, significantly reduce level of BDNF with not increasing incidence of adverse reactions.
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Hepatic cavernous hemangioma is the most common benign tumor of liver.Hepatic artery embolism chemotherapy is one of the commonly used treatment methods,but more and more related complications and sequelae have been reported recently,including obstructive jaundice caused by damaged biliary tract.Because the symptoms are not typical,obstructive jaundice might be misdiagnosed as malignant biliary tumor,which brought troubles to subsequent treatment.In this article,the clinical data of 2 patients with obstructive jaundice following transcatheter hepatic arterial chemoembolization for hepatic cavernous hemangioma were retrospectively analyzed,and the experience in the diagnosis and treatment of this disease was summarized.
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Objective To evaluate the clinical effects of combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization in the treatment of primary hepatic carcinoma. Methods 80 patients with primary hepatic carcinoma were randomly divided into a control group, treated by transcatheter hepatic arterial chemoembolization, and a treatment group, additionally treated by Fuyuan Huoxue decoction on the basis of the control group. By observing the change of gross tumor volume、tumor markers、clinical symptoms、Karnofsky Performance Status(KPS) score、quality of life and so on,compare the clinical effects and quality of life between the two groups. Results The effective rate of solid tumor was 47.50%and 35%in the treatment and the control group respectively, with no significant difference(χ2=-1.229, P>0.05);The total effect rate was 87.50%and 32.50%in the treatment and the control group respectively, with significant difference(χ2=-5.633, P0.05);The accumulated scores change of quality of life(QOL) has asignificant difference(χ2=-3.025, P<0.05) between the two groups after the treatment. Conclusion The combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization can alleviate the clinical symptoms, improve treatment effects and quality of life of patients with primary hepatic carcinoma.
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Hepatocellular carcinoma (HCC) accounts for more than 90％ of primary liver cancer.Surgical resection is the standard modality of treatment.However,resection can only be performed in a minority of patients at the time of diagnosis.Data from several recently published studies are encouraging and suggest that TACE (transcatheter hepatic arterial chemoembolization) is superior to conservative treatment in patients with hepatocellular carcinoma who are not eligible for surgery.The traditional embolic agents such as iodized oil and gelatin sponge significantly prolonged survival in patients with HCC.However,the effects of these embolic agents are temporary.A new embolic agent,microspheres has attracted a lot of attention in our country and abroad.These microspheres can be divided into two categories:pure microspheres and carrier microspheres.In this paper,we review these two types of microspheres.
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Objective To discuss the nursing measures for patients of hepatocellular carcinoma treated with transcatheter hepatic arterial chemoembolization(TACE)and hish intensive focus ultrasound (HIFU).Methods During the period of Aug.2008-Aug.2009,TACE together with HIFU were performed in 40 patients with hepatocellular carcinoma.The perioperative nursing measures were summarized.Results During hospitalization no severe complications,such as dangerous infection,intestinal bleeding,etc.occurred in all patients.Conclusion Correct and proper periopemtive nursing care is of significant importance for the prevention of complications and for the therapeutic effectiveness.
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Objective To study the cause of death and mechanism after(TACE)in China during the past 14 years.Methods Related repots in Chinese Medical Current Content(CBM)and National Knowledge lnfrastruc ture(CNKI)from January 1994 to June 2008 were retrieved.The cause of death and mechainsm after TACE wer e analyzed.Results A total of 150 patients who died after TACE were reposed in China during the past 14 ye ar s.84%eases were caused by liver lunction failure,upper gastrointestinal bleeding and rupture of liver cancer. 78.7%cases died one month postoperation.Conclusion Liver function failure.upper gastrointestinal bleeding and rupture of liver cancer are the main complications which Can cause death and the majority cases died early.
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Objective To observe the efficacy and toxicities of RF transparent heating (RTH) combined with transcatheter hepatic arterial chemoembolization (TACE) in the treatment of advanced primary hepatic carcinoma. Methods In a randomized manner, 69 patients with advanced primary hepatic carcinoma were divided into two groups: study group (TACE+RTH) 34 cases and control group (TACE alone) 35 cases, the control group were treated with DDP 80mg, FU 1000mg and E-ADM 60mg, E-ADM was used with iodized oil embolism 10ml. Results The total effective rate in the near future were 70.59% and 45.71%, the overall survival rates of 0.5, 1.0, 1.5, 2.0 years were 82.35%, 73.53%, 58.82%, 38.24% in study group and 74.29%, 75.14%, 45.71%, 22.86% in control group, respectively. Toxicities were similar comparing with the two groups. Conclusions RTH combined with TACE in the treatment of advanced primary hepatic carcinoma is better than TACE alone, at the same time TACE +RTH method is no increasing toxicity and is an effective safe combined one.
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Objective To compare the transcatheter hepatic arterial chemoembolization(TACE) combined percutaneous ethanol injection(PEI)in treating primary hepatic carcinoma and the simple TACE treatment. Methods 64 primary hepatic carcinoma patients were divided into union treatment group(n = 32)and TACE group(n = 32),with TACE combined PEI treatment and simple TACE treatment,respectively. The tumor size,AFP change,one year,two years,three years survival time and median survival time were observed and recorded during the course of treatment. Results The tumor shrinkage rates and the AFP transferring into negative rates of the union and simple TACE groups were 84.4%,62.7% and 77.4%,50% respectively after the treatment with significant difference between the two groups. The 1 years,2 years,3 years and median survival rates of the union and simple TACE groups were 96.9%,71.9%,37.5%,34.5 mo and 81.3%,31.3%,12.5%,19.5 mo,respectively,showing conspicuously significance of both groups. Conclusion TACE combined PEI for primary hepatic carcinoma is a better treatment of choice.