[Precision TACE in therapy of primary malignant tumors of liver/hepatocellular carcinoma (HCC)].

AIM: Hepatocellular carcinoma is one of the most frequent malignant tumors in general and most common liver malignancy. Aim of this study was to determine the therapeutic effect of chemoembolization with microspheres charged with doxorubicin in HHC patients. MATERIAL AND METHODS: During for period of four-year (November 2005- November 2009) at Institute of radiology CC Ni transarterial chemoembolization procedures (precision TACE) was performed on 27 patients. There were 17 male and 10 female patients with average age of 62 years. Total number of 64 TACE interventions were done in total, minimally one, maximally 6 per patient. HCC was pathophysiologically verified in all patients included in this study. After selective catheterization of tumor feeding artery, followed by application of microspheres a follow-up study with evaluation of therapeutic effects was conducted. RESULTS: Patients were enrolled in the study and followed four years in total. The therapy effects were estimated according to RECIST criteria. CONCLUSION: Precision TACE represents effective and controlled method for application of chemotherapeutic agencies with reduced systemic toxicity. Our preliminary results show increased therapeutic efficacy, diminished mortality and subsequently prolonged survival rate and improved quality of life in patients with HCC.

Management of painful spinal lesions caused by multiple myeloma using percutaneous acrylic cement injection.

BACKGROUND AND PURPOSE: Spinal lesions with marked destruction are common site of morbidity in patients with multiple myeloma causing serious clinical symptoms. The aim of the study was to evaluate the therapeutic benefit of percutaneous vertebroplasty (PVP) in treating vertebral body lesions in patients suffering from multiple myeloma. MATERIALS AND METHODS: Twenty nine patients (55 vertebral bodies) were treated after complete diagnostic evaluation, preparation and obtaining informed consent. Needle position and acrylic material injection was performed under fluoroscopic guidance. RESULTS: Average visual analogue score dropped from 7.8 before to 2.3 after the intervention. Soft tissue leak was present at 9 treated levels, small epidural cement collection at 5, venous leak at 4 and intradiscal leak at 3 levels without any clinically manifest complications. The effects of PVP were stable in all of the patients at 12 months follow-up. Subjective outcome scores collected through follow-up showed improvement of +1.45 in pain, + 1.15 in ambulation and + 1.23 in medication use. There were recurrence of back pain in 9 patients at non-treated levels due to the new lesions. CONCLUSION: In our series, PVP of painful lesions caused by multiple myeloma provides immediate and long-term pain relief. The procedure is safe and, despite of the present leakage of cement, may be performed on outpatients basis.