Transhepatic arterial chemoembolization with gemcitabine and carboplatin for the treatment of stage III hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficiency and safety of transhepatic arterial chemoembolization (TACE) with gemcitabine and carboplatin for the treatment of stage III hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Sixty-one HCC patients were treated by TACE. During TACE, At first, intra-arterial infusion of carboplatin 300 mg/m2, then gemcitabine 1000 mg/m2 with 5-30 ml of ultra-lipoidal iodide oil emulsion was used for arterial embolization. The toxicity and hepatic damage were observed according to WHO anticancer drug toxicity criteria and Child-Pugh classification criteria, respectively. The survival time was also observed during follow-up.</p><p><b>RESULTS</b>The blood toxicity was bone marrow suppression presented as grade I leucopenia in 39.3%, grade II in 29.5%, grade III-IV in 18.0%. Grade II-III nausea and vomiting developed in 96.8% of the patients. Hepatic function damage became aggravated in 16 patients from A to B class, in 2 from A to C class, and in 6 from B to C class according to Child-Pugh classification criteria. The median survival time was 20 months with a range of 5 to 3 5 months.</p><p><b>CONCLUSION</b>Transhepatic arterial chemoembolization using carboplatin and mixture of gemcitabine with ultra-lipoidal iodide oil emulsion is safe and effective in the management of stage III hepatocellular carcinoma. This regimen can also improve their quality of life.</p>

Relation between vascular endothelial growth factor and reoccurence-metastasis after transcatheter arterial chemoembolization in hepatocellar carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the relation between changes in serum vascular endothelial growth factor (VEGF) level after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) progression, especially in relation to metastasis.</p><p><b>METHODS</b>Serum VEGF expression level, measured by quatitative sandwich enzyme-linked immunosorbent assay (ELISA, R&D system), was measured before, 3 days and 4 weeks after TACE in 30 patients with HCC. The development of metastasis was evaluated at the end of the third month after TACE.</p><p><b>RESULTS</b>1. The serum VEGF level in 30 patients was 154.47 +/- 90.17 pg/ml, 2. Post-TACE total serum VEGF level increased as compared with their basal level in 30 patients (P < 0.05) and serum VEGF level had a tendency to increase in patients with heterogeneous uptake of iodized oil and portal vein thrombosis. During the follow-up of 1 - 2 years, metastatic foci were found in 74% (20) patients with SVEGF increase, while none of the patients showing SVEGF decrease developed metastasis.</p><p><b>CONCLUSION</b>Serum VEGF expression increase is associated with the development of metastasis in hepatocellular carcinoma after TACE.</p>