Tratamiento del hepatocarcinoma: ablación y embolización arterial / Hepatocellular carcinoma treatment: ablation and arterial embolization

Las técnicas percutáneas y endovasculares son importantes en el tratamiento de los pacientes con hepatocarcinoma. Los diferentes métodos de ablación percutánea, especialmente indicados en tumores de hasta 2cm de diámetro, ofrecen resultados, cuanto menos, similares a los de la resección quirúrgica. Aprovechando la doble vascularización hepática y la nutrición tumoral exclusiva por la arteria se han desarrollado varias maneras de tratar, endovascularmente, al tumor. La administración intraarterial de partículas embolizantes, solas o cargadas con fármaco (quimioembolización), producirá isquemia y necrosis con excelentes resultados en pacientes con hepatocarcinoma multinodular en estadio intermedio (BCLC-B). Determinado tipo de partículas pueden ser exclusivamente vehiculantes de un agente terapéutico; cuando se les incorpora un radioisótopo facilitan la irradiación selectiva intratumoral directa (radioembolización). Esta técnica ha demostrado su eficacia en lesiones que no pueden ser tratadas con otros métodos, y debería considerarse, junto con la ablación y la quimioembolización, en los algoritmos terapéuticos del hepatocarcinoma

Percutaneous and endovascular techniques take an important role in the therapeutic management of patients with hepatocarcinoma. Different techniques of percutaneous ablation, especially indicated in tumors up to 2cm diameter offer, at least, similar results to surgical resection. Taking advantage of double hepatic vascularization and exclusive tumor nutrition by the artery, several endovascular techniques of treating the tumor have been developed. Intra-arterial administration of embolizing particles, alone or charged with drug (chemoembolization), will produce ischemia and consequent necrosis with excellent results in selected patients. Certain types of particles may exclusively be carriers of a therapeutic agent when they incorporate a radioisotope that facilitates the direct intratumoral selective irradiation (radioembolization). This technique has demonstrated its efficacy in lesions not susceptible to be treated with other methods and should be considered, together with ablation and chemoembolization, in the therapeutic algorithms of hepatocarcinoma

Molecular Mechanics Study of the Inclusion Complexes of 2-Methyl Naphthoate with alpha- and beta-Cyclodextrins

Molecular mechanics calculations were employed to study the inclusion of 2-methyl naphthoate in alpha- and beta-cyclodextrin in vacuo and in the presence of water as a solvent. The driving forces for complexation are dominated by nonbonded van der Waals host:guest interactions in both environments. The 2-methyl naphthoate penetrates completely into the cavity of beta-cyclodextrin, but there is only partial penetration by the same molecule into the smaller cavity of alpha-cyclodextrin. Copyright 1997Academic Press