To evaluate the safety and efficacy of transarterial arterial chemoembolization (TACE) with gelatin sponge particles (GSPs-TACE) and Huaier granule to treat primary hepatic carcinoma (PHC).A series of 62 patients with PHC were included between June 2009 and December 2011, and randomly assigned to a control (n = 31) or an experimental group (n = 31). The control patients received TACE with 350 to 560 μm GSPs plus lobaplatin chemotherapy. Patients in the experimental group received TACE plus Huaier granule. Treatment safety and mid-to-long-term efficacy were evaluated.Follow-up ranged from 12 to 24 months with a mean of 28.7 months. The 6- and 12-month overall survivals were 100% and 93.5% in the experimental group and 90.3% and 80.6% in control group, respectively. The difference in overall survival at 12 months was significant (χ2 = 5.213, P < .05), but the difference in median survival in the experimental group (20.6 months) and control group (17.1 months) patients was not significant (χ2 = 0.745, P > .05). The number of TACE procedures in the experimental group (2.9 ± 8.7) and control group (4.1 ± 7.3) patients was significantly different (χ2 = 7.262, P < .05). The 6-month (87.1% vs. 73.3%, χ2 = 5.945) and 12-month (72.4% vs. 64.3%, χ2 = 6.384) tumor objective response rates in the experimental and control groups were significantly different (P < .05). There were no statistically significant differences in the occurrence of treatment-related adverse reactions in the 2 groups.Transarterial chemoembolization with GSPs and Huaier granule was safe and effective for treating PHC patients.
Background: To observe the medium-and long-term clinical efficacy and safety of radioactive 125 I seed implantation for refractory malignant tumours based on CT-guided 3D template-assisted technique. Methods: Twenty-five patients with refractory malignant tumours who underwent radioactive 125 I seed implantation based on CT-guided 3D template-assisted technique were selected. The post-operative adverse reactions were recorded. The number of puncture needles and particles used in the operation, dosimetric parameters, post-operative physical strength scores, and tumour response were statistically analysed. The overall survival time and survival rate were calculated, and the effect and prognosis were assessed.
Spontaneous rupture of hepatocellular carcinoma hemorrhage is life-threatening. The aim of the present study was to retrospectively analyze the effect of gelatin sponge microparticles (GSMs) of various diameters on the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSMs serve as embolization agents by transcatheter arterial chemoembolization (TACE), and the current study analyzed their safety and efficacy. Data from a total of 13 cases of spontaneous rupture of hepatocellular carcinoma hemorrhage, who were treated with GSM-TACE at the Affiliated Zhongshan Hospital of Dalian University (Dalian, China) between August 2010 and June 2014, were collected. Post-operative complications were classified according to the National Cancer Institute Common Terminology Criteria. Review computed tomography was conducted 1, 3 and 6 months after GSM-TACE treatment in order to determine the occurrence of re-bleeding; the tumor response was evaluated based on the Modified Response Evaluation Criteria In Solid Tumors and the expression levels of α-feroprotein. The patients were followed-up for 1-6 months (average, 5.15±1.67 months). Following GSM-TACE treatment, 13 cases reached successful hemostasis without technical complications. The survival rates 1, 3 and 6 months after treatment were 76.9 (10/13), 61.5 (8/13) and 53.8% (7/13), respectively; the objective response rates were 61.6, 53.9 and 38.5%, respectively. The primary post-operative complications were pain (100%), nausea and vomiting (69.2%), and fever (53.8%). Among the 13 patients, 2 cases underwent surgical excision 10 and 30 days after GSM-TACE, and 1 case experienced re-bleeding 3 months after treatment, after which the patient received a second treatment with TACE and successful achieved hemostasis. In conclusion, GSM-TACE of various diameters is a safe and effective method in the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSM-TACE is able to achieve immediate hemostasis and improves the survival rate of patients, thus creating favorable conditions for follow-up treatment.
Gelatin sponge particles are commonly used in the conventional transarterial chemoembolization (c-TACE) as an adjuvant embolizing agent for hepatocellular carcinoma (HCC). However, there are few reports regarding the clinical applications of gelatin sponge microparticles (GSMs) as a main embolizing agent in the treatment of HCC. This retrospective study aim to evaluate the efficacy and safety of patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC treated with intra-arterial injection of 350 to 560 μm GSMs mixed with anticancer agents.Twenty-four patients with unresectable BCLC stage B HCC without any prior treatment underwent transarterial chemoembolization with gelatin sponge microparticles (GSMs-TACE) of diameter 350 to 560 μm mixed with lobaplatin. The mixture was injected into tumor-feeding arteries until the sluggish flow in selective artery. Safety was measured by assessing complication rate, and efficacy was reflected by assessing response to mRECIST therapy and overall survival. The survival rate was calculated using the Kaplan–Meier method.All 24 BCLC stage B HCC patients showed good tolerance to the procedure. The mean follow-up period was 27 months and mean number of TACE treatments per patient was 3.7 sessions (range 1–10) during the follow-up period. Postprocedure complications were mild and treated by symptomatic treatment. Six months and 1 year overall survival rates were 100% and 87.5%, respectively. Overall median survival time was 25 months (95%CI: 21.06–28.95 months).GSMs-TACE is a safe and effective method for BCLC stage B HCC patients.
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