Safety and efficacy analysis of hepatic artery infusion chemotherapy combined with immune targeted therapy for single CNLC Ⅰb hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To investigate the safety and efficacy of FOLFOX (5-fluorouracil + calcium folinate + oxaliplatin) hepatic arterial infusion chemotherapy (FOLFOX-HAIC) combined with immune and targeted therapy as triple combination therapy for patients with single China Liver Cancer Staging (CNLC) Ⅰb hepatocellular carcinoma.Methods:A total of 20 patients with single CNLC Ⅰb hepatocellular carcinoma who received FOLFOX-HAIC combined with immune and targeted therapy as triple combination therapy in the First Affiliated Hospital of Guangxi Medical University from October 2021 to August 2022 were included. The clinical data of all patients was retrospectively analyzed. There were 18 males and 2 females, with the age of (55.1±9.9) years. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Modified Response Evaluation Criteria in Solid Tumors (mRECIST) were used to evaluate the efficacy of FOLFOX-HAIC combined with immune and targeted therapy, and the clinical safety of triple combination therapy was evaluated by common terminology criteria for adverse events 4.0.Results:According to RECIST 1.1, objective response rate of 20 patients was 70.0% (14/20) and disease control rate was 100.0% (20/20) after 2 cycles of treatment (one cycle of FOLFOX-HAIC plus programmed death-1 antibody). According to mRECIST, objective response rate was 90.0% (18/20) and the disease control rate was 100.0% (20/20) after 2 cycles of treatment. Following the treatment, 12 patients (60.0%) received liver tumor resection, and all of them achieved R 0 resection, 2 patients (10.0%) received radiotherapy, 3 patients (15.0%) stopped drug treatment for surgery, 2 patients (10.0%) refused surgery, and 1 patient (5.0%) died of multiple organ failure caused by immune hepatitis. According to pathological results, 3 patients (25.0%, 3/12) achieved pathological complete response, and 4 patients (33.3%, 4/12) achieved major pathological response. In the safety evaluation, the overall incidence of adverse events was 100.0% (20/20). Seven patients (35.0%) had grade 3 adverse events and 1 patient (5.0%) died of multiple organ failure due to immune hepatitis (grade 5). Grade 1-3 adverse events could be relieved after symptomatic treatment. Conclusion:The triple combination therapy of FOLFOX-HAIC combined with immune and targeted therapy is safe and has high objective response rate and disease control rate, which could be a new strategy for the neoadjuvant treatment of hepatocellular carcinoma.

Advances in neoadjuvant therapy for hepatocellular carcinoma / 中华消化外科杂志

In recent years, the rapid development of systematic therapy and local therapy, represented by targeted therapy, immunotherapy and vascular interventional therapy, has signifi-cantly improved the therapeutic effects of advanced hepatocellular carcinoma (HCC), and also greatly promoted the development of neoadjuvant therapy of HCC. The main purpose of neoadjuvant therapy is to decrease the size of tumor and the difficulty of surgery, and to reduce the postoperative recurrence rate. But meanwhile it also brings potential risks such as tumor progression and loss of surgical opportunity. At present, most experts recommend that patients with Ⅱb stage and Ⅲa stage HCC according to China Liver Cancer staging system are the preferred target population for neoadjuvant therapy. However, due to the lack of high-quality medical evidence, it is recommended to be cautiously carried out after multidisciplinary discussion. Moreover, it is suggested that neoadjuvant therapy with rapid onset of effect, less and mild side effects, high objective response rate and low probability of disease progression should be carried out. The author expects that neoadjuvant therapy can further improve the prognosis of HCC, and provide more options for clinical practice.

Clinical efficacy of hepatic arterial infusion chemotherapy combined with immune plus targe-ted therapy for lung metastasis of advanced hepatocellular carcinoma / 中华消化外科杂志

Hepatocellular carcinoma (HCC) is one of the most common tumors of primary hepatic carcinoma, and one of the major causes of cancer related deaths worldwide. HCC has high incidence and mortality, with limited treatment. The prevention and treatment of HCC faces great challenges. At present, interventional therapy combined with immune plus targeted therapy has a synergistic effect and a significant effect in prolonging the survival time of patients and controlling tumors, which brings a brand-new therapeutic hope to patients with advanced HCC. The authors report a case of advanced HCC with lung metastasis who underwent hepatic arterial infusion chemotherapy combined with immune plus targeted therapy, with a result of good clinical effect on tumor controlling in a short time.

Research progress of vascular interventional therapy in the conversion therapy of hepato-cellular carcinoma / 中华消化外科杂志

Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, which poses a serious threat to the life and health of the Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of the pathology of primary liver cancer, among them around 60% of patients are at the intermediate-advanced stage when diagnosed. Therefore, increasing the rate of resection via conversion therapies is particularly important to improve the prognosis of these patients. Vascular interventional therapies represented by transarterial chemoembolization and hepatic arterial infusion chemotherapy are important treatment methods for HCC patients in intermediate-advanced stage, showing good rates of tumor response and surgical conversion. Combined with research data at home and abroad, the authors analyze research progress of vascular interventional therapy in the conversion therapy of HCC, review the history and the strategies of conversion therapies based on vascular interventional therapy in this article.

Construction of nursing quality evaluation index system of bronchial arterial infusion chemotherapy for lung cancer / 中国实用护理杂志

Objective:To construct the nursing quality evaluation index system of bronchial arterial infusion chemotherapy for lung cancer, and to provide theoretical basis for nursing quality evaluation of patients undergoing bronchial arterial infusion chemotherapy.Methods:Based on the structure-process-result three-dimensional quality theory, relevant literature and clinical practice were retrieved to construct the index item pool of the nursing quality evaluation index system of bronchial arterial infusion chemotherapy for lung cancer, and the index items were determined by expert interviews. Finally, the index and its weight were determined by Delphi method and analytic hierarchy process.Results:The positive coefficients of the two rounds of expert letter consultation were 100%, the expert authority coefficients were 0.862, and the expert coordination coefficients were 0.141-0.250 ( P<0.05). The At finally, the nursing quality evaluation index system of bronchial arterial infusion chemotherapy for lung cancer included 3 first-level indexes, 10 second-level indexes and 47 third-level indexes. Conclusions:The nursing quality evaluation index system of bronchial arterial infusion chemotherapy for lung cancer is scientific and practical, which provides a scientific basis for evaluating the nursing quality of patients undergoing bronchial arterial chemotherapy for lung cancer.

A rare case of cerebral hemorrhage associated with intra-arterial infusion chemotherapy for advanced sphenoid sinus cancer

Central nervous damage related to intra-arterial infusion chemotherapy (IAC) for head and neck cancer reported to date are cerebral infarction, transient ischemic attack, and neuropathy. There have been no reports of cerebral hemorrhage as an IAC-related complication for head and neck cancer. Authors report a case that underwent intra-arterial infusion chemoradiotherapy for advanced sphenoid sinus cancer which extended to the left cavernous sinus and cranium, subsequently suffered cerebral hemorrhage thought to have been caused by IAC. Treatment should be performed with greater caution when the head and neck cancer involves the cavernous sinus or cranium, as in the present case

Transcatheter arterial infusion of anti-programmed cell death 1 antibody pembrolizumab combined with temozolomide or nab-paclitaxel in patient with primary anorectal malignant melanoma: Four case reports

Primary anorectal malignant melanoma (ARMM) is an extremely rare but aggressive tumor. We assessed the efficacy and safety of transcatheter arterial infusion (TAI) with anti-PD-1 antibody pembrolizumab at a dosage of 100 mg with 0.9% NaCl at a volume of 100 mL administered over a 30-min period every 3 weeks, combined with temozolomide or albumin-bound paclitaxel (nab-paclitaxel) in four patients with ARMM. Temozolomide was administered orally once per day at a dosage of 200 mg/m2/d for five consecutive days about every 4 weeks. Nab-paclitaxel was administered at a dosage of 200mg/m2/d once about every 3 weeks. Among four patients with a median follow-up of 8.9 months, two cases showed Murine Double Minute 2 (MDM2) amplification. Case 1 with Stage II ARMM showed pathological complete response after four cycles of TAI with pembrolizumab combined with nab-paclitaxel. Case 4 was at Stage II and showed stable disease consistently throughout the treatment. Case 2 was at stage II and Case 3 was at stage III, and they showed partial response after four or three cycles, respectively, of TAI with pembrolizumab combined with temozolomide. No Grades 3–4 adverse reactions were observed. Therefore, a combination of TAI with pembrolizumab and temozolomide or with nab-paclitaxel appears to be a promising option for treating ARMM. However, multicenter clinical trials are required to confirm the efficacy and safety of this procedure

The application of pre-filled SS-Y valve fixation in patients undergoing transcatheter arterial infusion chemotherapy / 中国实用护理杂志

Objective@#To improve the problems of catheter occlusion, low comfort of patients and low satisfaction of nurses, the pre-filled SS-Y valve fixation method was used for catheter nursing.@*Methods@#Traditional method of arterial catheter nursing were performed in 54 patients with malignant tumors of digestive tract treated by transcatheter arterial infusion chemotherapy (TAI) (control group) from April 1 to December 31, 2017 in the Department of Radiation Intervention, the Affiliated Second Hospital of Medical College of Zhejiang University. Pre-filled SS-Y valve fixation method was used for arterial catheter nursing in 72 patients treated with TAI (observation group) from January 1 to September 30, 2018. The fixation, comfort and satisfaction of nurses were compared between the two groups.@*Results@#The rate of arterial catheter displacement, slippage and satisfaction of nurses were 0, 0 and 97.22% (70/72) in observation group, and 13.0% (7/54), 5.6% (3/54), 77.78% (42/54) in control group. Significant statistic differences were found between two groups in rate of arterial catheter displacement and comfort scores (χ2=9.882, 11.813, P<0.01). There was no significant difference in slippage between the two groups (P>0.05). The comfort scores of the patients in observation group at 5 time points were better than those in control group, and the difference was statistically significant (Z=-6.462--3.611, P < 0.01).@*Conclusions@#The method of pre-filled SS-Y valve fixation is reliable with a low displacement rate and a higher satisfaction for both patients and nurses. This method can be popularized in clinical nursing.

Hepatic Arterial Infusion Chemotherapy in the Era of Precise Medicine / 中山大学学报(医学科学版)

@# Hepatocellular carcinoma（HCC）is the most common malignant liver tumor in the world. Hepatectomy， liver transplantation and ablation may be the potential radical treatments for early liver cancer patients. At present，most of the patients with HCC in China are in the late stage of the disease，mainly requiring systematic treatment. Sorafenib and Lenvatinib are internationally recognized as first-line therapy for advanced HCC. In Asia，hepatic arterial infusion chemotherapy（HAIC）is used as a first-line regimen for the treatment of advanced HCC. In HAIC，antineoplastic drugs are directly injected into the blood supply vessels of liver tumors，obtaining high reaction rate and obvious survival advan⁃ tages，and reducing the systemic toxicity and side effects of chemotherapy drugs. However，HAIC is not yet widely used worldwide due to the lack of accurate evidence from randomized controlled clinical trials（RCT）targeting global populations. In this paper，we will systematically review the current research status of HAIC and its dominant population. More⁃ over，we speculate that HAIC will be the standard therapy for advanced HCC or combined with tyrosine kinase inhibitor （TKI）and / or immunotherapy to prolong these patients′ life in the near future.

Clinical significance of microvascular invasion in the comprehensive diagnosis and treatment of hepatocellular carcinoma / 中华消化外科杂志

Microvascular invasion (MVI) is one of the invasive characteristics of hepatocellular carcinoma (HCC) and also an independent risk factor for intrahepatic and distant metastasis of hepatocellular carcinoma.The occurrence of MVI in patients with hepatocellular carcinoma is universal and can occur in different stages of hepatocellular carcinoma,which is the result of the joint action of multiple factors,including tumor diameter,tumor morphology,tumor pathological grading,and hepatitis B virus activity and replication.For patients with preoperative assessment of MVI risk factors,reasonable surgical plans should be made according to the basic conditions of patients.Non-anatomic hepatectomy is performed to expand the resection scope as far as possible (at least ＞ 1 cm),and anatomic hepatectomy is performed with complete Laennec cystectomy along the Glisson system.Pathological examination is the gold standard of MVI diagnosis,and standardized diagnosis can improve the detection rate of MVI.MVI is mainly related to early postoperative recurrence of hepatocellular carcinoma (within 1 year).For patients with positive MVI after HCC resection,selective combination with transcatheter arterial chemoembolization,radiotherapy and molecular targeted drugs can reduce tumor recurrence and prolong the survival time of patients with liver cancer without recurrence.Therefore,MVI has important clinical significance for the comprehensive diagnosis and treatment of hepatocellular carcinoma.

A Case of Complete Response with Biliary Stenosis after Hepatic Arterial Injection and Stereotactic Body Radiotherapy to Hepatoecllular Carcinoma with Portal Vein Thrombosis

Curative treatment of hepatocellular carcinoma (HCC) with portal vein invasion is difficult to achieve, and the prognosis is dismal. Combining external beam radiotherapy (EBRT) with hepatic arterial infusion chemotherapy (HAIC) has shown favorable local therapeutic effects for patients with HCC exhibiting portal vein invasion. Stereotactic body radiotherapy (SBRT) is a recently developed EBRT modality that shows excellent tumor control. The combination of SBRT and HAIC for HCC with portal vein invasion has not been well-studied. We report a patient with HCC and portal vein invasion who achieved 15 months of survival with complete response status after combination SBRT and HAIC. The patient later experienced grade 3 biliary stricture and died of liver abscesses of unknown etiologies that subsequently appeared.

Transcatheter arterial infusion chemotherapy followed by surgery in patients with unresectable stage III non-small cell lung cancer / 肿瘤

Objective: To evaluate the clinical response, adverse reactions and prognosis of transcatheter arterial infusion (TAI) chemotherapy followed by surgery in patients with unresectable stage III non-small cell lung cancer (NSCLC). Methods: A retrospective study was performed in 81 patients with unresectable stage III NSCLC. All patients received 2 cycles of TAI chemotherapy. Surgical treatment was performed for patients with partial response or patients with stable disease and tumor reduction. The primary endpoint was overall survival (OS) and the secondary endpoints were disease control rate (DCR) and adverse reactions. Results: The results of response evaluation after 2 cycles of TAI chemotherapy were partial response in 40 patients (49.4%), stable disease in 30 patients (37.0%) and disease progression in 11 patients (13.6%); the DCR was 86.4% (70/81). The main adverse reactions were graded as I-II. In 55 patients undergoing TAI chemotherapy, the surgical resection rate was 94.5% (52/55), and the postoperative complication rate was 32.7% (18/55); the 1-, 2- and 3-year survival rates were 78.2%, 52.7% and 34.5%, respectively. The subgroup analysis showed that the OS of the patients with partial response was significantly better than that of the patients with stable disease; the median survival time were 37.0 and 21.0 months, respectively (P = 0.01 9). The median survival time (34.0 months) of the patients diagnosed of squamous cell carcinoma was longer than that of the patients diagnosed of adenocarcinoma (13.5 months), but the difference was not statistically significant (P = 0.101). The results of multivariate analysis showed that the short-term response was an independent prognostic factor, and the prognosis of patients achieving partial response was better than that of the patients achieving stable disease (the hazard ratio was 0.467, the 95% confdence interval was 0.238 to 0.916; P = 0.027). Conclusion: For patients with unresectable stage III NSCLC, TAI chemotherapy is an effective and safe neoadjuvant therapy, especially for patients with partial response or preoperative diagnosis of squamous cell carcinoma, and the postoperative survival benefits are more significant.

Efficacy and safety of continuous regional arterial infusion to treat patients with severe acute pancreatitis / 中华肝胆外科杂志

Objective To investigate the efficacy and safety of continuous regional arterial infusion (CRAI) in patients with severe acute pancreatitis (SAP).Methods One hundred SAP patients (including 41 gallstone,26 alcoholism,13 hypertriglyceridemia,11 after heavy meals,and 9 unknown) who were admitted into our hospital from January 2013 to October 2017 were assigned to the CRAI group (n =58) and the control group (n =42).The levels of laboratory measurements,hospitalization time and costs,complications and outcomes were compared between the two groups.Results On the sixth and tenth day of treatment,the levels of white blood cell,hemodiastase,urine amylase,blood glucose,blood calcium and APACHE-Ⅱ score improved in both the 2 groups.The degrees of improvement in the CRAI group were better than that in the control group.The abdominal pain relief time [(3.3± 1.2)d vs.(5.9±2.3)d],hemodiastase recovery time [(7.9±1.8)d vs.(13.3±2.5)d],and hospitalization stay [(21.3±3.6)d vs.(32.4±4.3)d] were shorter in the CRAI group.The costs were similar in the two groups.Retroperitoneal infection,pancreatic pseudocyst,and pancreatic drainage were less in the CRAI group.The improved and cure rates were 94.8％ and 70.7％ in the CRAI group,which were higher than those in the control group (71.4％ and 47.6％,respectively).Moreover,the ineffective treatment and mortality rates were 5.2％ and 1.7％ in the CRAI group,which were lower than those in the control group (28.6％ and 14.3％,respectively).Conclusions CRAI was an efficacious and safe treatment for patients with SAP.It can be used as an alternative to other effective treatments.

Pharmacokinetic analysis of raltitrexed using different ways of drug delivery / 介入放射学杂志

Objective To study the pharmacokinetics of raltitrexed using different ways of drug delivery, including femoral venous infusion, hepatic artery perfusion, hepatic artery injection of lipiodol suspension, hepatic artery perfusion followed by embolization with Gelfoam. Methods According to the administration way of raltitrexed, a total of 40 New Zealand rabbit models with VX2 liver tumor were randomly divided into group A (femoral venous perfusion), group B (hepatic arterial perfusion), group C (hepatic artery injection of lipiodol suspension), and group D(hepatic artery perfusion followed by embolization with Gelfoam). Drug concentration in plasma were determined by using LC-MS/MS method and the pharmacokinetic parameters were calculated. Results After administration of raltitrexed, the Tmax was 5 minutes in all 4 groups. In group A, B, C and D, the values were (5.88±1.39), (7.31±2.60), (9.86±5.10) and (7.19±2.27) respectively, with group C having the longest t1/2 value, which was significantly different with that of group A (P＜0.05); the (ng·ml-1·h-1) values were (2 056.40± 139.17), (1 389.21±180.28), (911.84±105.62) and (1 133.41±181.42)respectively, with the value of group A being obviously higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest; the AUC0-t(ng· ml-1·h-1) values were (5 482.72±1 007.07), (4 156.99±1 475.77), (2 785.13±1 107.36) and (3 903.64±947.25) respectively, with the value of group A being remarkably higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest. Conclusion Compared with the femoral vein infusion way, the ways of hepatic artery infusion, hepatic artery lipiodol suspension injection and hepatic artery perfusion followed by embolization with Gelfoam may promote more raltitrexed to deposit in the tumor area, thus, the curative effect is enhanced, the drug concentration in plasma is lowered and the side effects are alleviated.

Effect of super selective intra-arterial infusion of verapamil for the treatment of cerebral vasospasm after subarachnoid hemorrhage:an efficacy analysis / 中国脑血管病杂志

Objective To investigate the efficacy of super selective intra-arterial infusion of verapamil for the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods From January 2013 to February 2016,the clinical data of 15 patients with subarachnoid hemorrhage (SAH) who had CVS after intracranial aneurysm clipping (n=8) or endovascular treatment (n=7) were analyzed retrospectively.All patients received whole brain digital subtraction angiography (DSA).Microcatheter super selection to spastic arteries was used and verapamil (11.1±3.4 mg) was infused.The findings of whole brain DSA before and after treatments were compared.The blood pressure and heart rate were collected during the treatment and the findings of transcranial Doppler ultrasonography were recorded.The patients were followed up for 6 months and the Glasgow outcome scale (GCS) scores were obtained.Results (1) A total of 20 intra-arterial infusion treatments were performed in 15 cases.They were compared before and after perfusion.CVS was improved on DSA in 14 cases,there was no significant change in on cases.(2) Transcranial Doppler ultrasonography showed that the mean blood flow velocity (mBFV) of the middle cerebral artery was decreased from 181±4 cm/s before the super selective intra-arterial infusion to 126±4 cm/s within 1 hour after treatment.There was significant difference (t=42.46,P0.05).(4) All patients were followed up for 6 months.The GOS score at 6 months:good recovery in 9 cases,moderate disability but could take care of themselves in 3 cases,severe disability and could not take care of themselves in 3 cases,no persistent vegetative state or death.Conclusion Super selective intra-arterial infusion of verapamil can effectively improve the treatment of aneurysmal SAH caused CVS.At the same time,it has no obvious effect on blood pressure and heart rate.

Clinical observation of somatostatin combined with transcatheter arterial infusion chemotherapy in the treatment of malignant intestinal obstruction / 中国生化药物杂志

Objective To observe the effect of somatostatin combined with transcatheter arterial infusion chemotherapy in the treatment of malignant intestinal obstruction.Methods 60 patients with malignant intestinal obstruction were enrolled in our hospital from January 2013 to June 2015.The rats were randomly divided into 4 groups: the conventional group(n=15),the growth inhibition group(n=15),the low dose intra-arterial infusion chemotherapy group(n=15)and somatostatin plus low-dose intra-arterial infusion chemotherapy group(n=15).The clinical symptom remission time,duration of clinical symptom remission and survival time were compared between the four groups.Results The study showed that somatostatin group of gastrointestinal decompression and symptom remission time were significantly better than the conventional group.Especially the symptom remission time is significantly faster than the conventional group and chemotherapy group(P< 0.05); the duration of chemotherapy group and somatostatin+artery perfusion chemotherapy group in survival time and relieve symptoms,were significantly better than the conventional group and somatostatin group(P< 0.05).Conclusion Somatostatin is beneficial to reduce the amount of gastrointestinal decompression in the treatment of malignant intestinal obstruction.Celiac artery infusion chemotherapy can help to improve the maintenance time and prolong the survival time of patients with malignant obstruction.The combination of somatostatin and celiac artery infusion chemotherapy is beneficial to relieve the symptoms and prolong the time interval,and improve the survival time of patients.

Effect of Huachansu capsule combined with hepatic arterial infusion chemotherapy on plasma fibrinogen and tumor marker boncentration in patients with Hepatocellular carcinoma / 中国生化药物杂志

Objective To study the effects of cinobufotalin capsule combined with transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.Methods 68 patients with hepatocellular carcinoma from January,2013 to March,2016 were selected and divided into the combination group and chemotherapy group according to the random number table method,each with 34 cases.The combination group was treated with transcatheter arterial chemoembolization and hepatic artery infusion chemotherapy embolization.The levels of D-dimer,tumor markers,clinical efficacy and quality of life scores were observed before and after treatment in 68 patients.Results There was no significant difference in plasma fibrinogen(FIB)in combination group before and after treatment.Before treatment,the levels of FIB)was similar to chemotherapy group.After treatment,the FIB content in the chemotherapy group was significantly higher than before treatment and that in the combination group the differences were statistically significant(P<0.05).After treatment,the levels of cytokeratin 19,carcinoembryonic antigen and neuron-specific enolase in two group were significantly higher than those before treatment(P<0.05).But there was no significant difference between the two groups after treatment.The rate of disease control in the combination group was significantly higher than that in the chemotherapy group(77.5％vs.65.4％,P<0.05).Cases of diarrhea and insomnia in chemotherapy group were similar to the combination group,but the differences of cases of pain and fatigue between two group were statistically significant(P<0.05).Conclusion Cinobufotalin capsule combined with transcatheter arterial chemoembolization can improve the hypercoagulability of the patient's blood,and is beneficial to the treatment of cancer,improve the disease control rate and improve the life of patients.

TACE combined with IMRT for the treatment of advanced hepatocellular carcinoma: observation of its curative effect / 介入放射学杂志

Objective To evaluate the curative effect of transcatheter arterial chemoembolization (TACE) combined with intensity modulated radiation therapy (IMRT) in treating advanced hepatocellular carcinoma (HCC),and to discuss the occurrence of adverse events.Methods A total of 59 patients with advanced HCC were enrolled in this study.The patients were randomly divided into TACE plus IMRT group (study group,n=30) and TACE group (control group,n=29).The early tumor response rate,progression free survival (PFS),median survival time (mST),and adverse reactions were analyzed.Results The early tumor response rate in the study group was 60.0％,which was significantly higher than 34.4％ in the control group (P=0.043).PFS of the study group was 260 days,which was remarkably higher than 195 days of the control group (P=0.006).The mST was 468 days in the study group,which was 431 days in the control group (P=0.195).In the study group,2 patients developed severe liver function damage,which was improved after active liver protection therapy for more than 20 days.Conclusion For the treatment of advanced HCC,TACE combined with IMRT can improve early tumor response rate and prolong PFS time,moreover,its adverse reactions can be well tolerated by patients.

Can metronomic chemotherapy be an alternative to sorafenib in advanced hepatocellular carcinoma?

No abstract available.

Treatments Other than Sorafenib for Patients with Advanced Hepatocellular Carcinoma

Sorafenib is the standard treatment for advanced hepatocellular carcinoma according to the Barcelona Clinic Liver Cancer staging system. However, because of its unsatisfactory efficacy, adverse effects, and high cost, the use of sorafenib is limited, and other treatment modalities are required. Recent studies reported that treatment modalities other than sorafenib, such as hepatic arterial infusion chemotherapy and transarterial radioembolization, showed comparable or better response rates and survival rates than sorafenib. In this review, treatment modalities that could be used as alternatives to sorafenib will be discussed.