Transarterial Chemoembolization for the Palliation of Painful Bone Metastases Refractory to First-Line Radiotherapy

Heianna, Joichi; Makino, Wataru; Toguchi, Masafumi; Iraha, Tomotaka; Ishikawa, Kazuki; Kusada, Takeaki; Maemoto, Hitoshi; Takehara, Shota; Ariga, Toshio; Murayama, Sadayuki

doi:10.1016/j.jvir.2020.10.031

“…Since Goldstein first reported the treatment of HCC with TACE in 1976, TACE has been rapidly developed and further developed worldwide[ 11 , 28 ]. TACE is mainly suitable for patients with unresectable HCC and well liver function, and its efficacy is positive, which can improve the survival rate of HCC patients in this stage[ 2 , 29 - 31 ]. However, TACE is difficult to achieve a radical cure of cancer due to factors such as ectopic blood supply, angiogenesis, and portal vein blood supply around the tumor, and the tumor control rate of TACE alone is only about 20%[ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety analysis of transarterial chemoembolization and transarterial radioembolization in advanced hepatocellular carcinoma descending hepatectomy

Feng¹,

Cheng²,

Song³

et al. 2023

World J Gastrointest Surg

View full text Add to dashboard Cite

BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, which is seriously threatening the lives of patients. Due to the rapid development of the disease, patients were in the middle and advanced stages at the time of diagnosis and missed the best time for treatment. With the development of minimally invasive medicine, interventional therapy for advanced HCC has achieved promising results. Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are currently recognized as effective treatments. This study aimed to investigate the clinical value and safety of TACE alone and combined with TACE in the treatment of progression in patients with advanced HCC and to find a breakthrough for the early diagnosis and treatment of patients with advanced HCC. AIM To investigate the efficacy and safety of hepatic TACE and TARE in advanced descending hepatectomy. METHODS In this study, 218 patients with advanced HCC who were treated in the Zhejiang Provincial People’s Hospital from May 2016 to May 2021 were collected. Of the patients, 119 served as the control group and received hepatic TACE, 99 served as the observation group and were treated with hepatic TACE combined with TARE. The patients in two groups were compared in terms of lesion inactivation, tumor nodule size, lipiodol deposition, serum alpha-fetoprotein (AFP) level in different periods, postoperative complications, 1-year survival rate, and clinical symptoms such as liver pain, fatigue, and abdominal distension, and adverse reactions such as nausea and vomiting. RESULTS The observation group and the control group had good efficacy in treatment efficiency, reduction of tumor nodules, reduction of postoperative AFP value, reduction of postoperative complications, and relief of clinical symptoms. In addition, compared with the control group, the treatment efficiency, reduction of tumor nodules, reduction of AFP value, reduction of postoperative complications, and relief of clinical symptoms in the observation group were better than those in the TACE group alone. Patients in the TACE + TARE group had a higher 1-year survival rate after surgery, lipiodol deposition was significantly increased and the extent of tumor necrosis was expanded. The overall incidence of adverse reactions in the TACE + TARE group was lower than that in the TACE group, and the difference had statistical significance ( P < 0.05). CONCLUSION Compared with TACE alone, TACE combined with TARE is more effective in the treatment of patients with advanced HCC. It also improves postoperative survival rate, reduces adverse effects, and has a better safety profile.

show abstract

“…38 39 Most recently, transarterial chemoembolization has been proposed for tumor control and pain relief in patients with bone metastases. 40 Heianna et al recently conducted a retrospective review of 50 patients comparing radiation therapy with chemoembolization in patients with bone metastases. More than half of the treated bone lesions were in the spinal column.…”

Section: Vertebral Embolizationmentioning

confidence: 99%

Interventional Management of Painful Vertebral Body Metastases

Sajan

¹

,

Isaacson²,

Bagla³

2022

Semin intervent Radiol

1

0

View full text Add to dashboard Cite

Management of osseous metastatic disease has advanced over the years with the advent of ablation and interventional technologies. Painful metastatic vertebral body lesions have been particularly studied in the recent years, as open surgery is usually reserved for emergent cord compression. Minimally invasive options in managing these lesions include percutaneous vertebral augmentation, percutaneous ablation, and embolization. This article will include an overview of these procedures including the most recent literature.

show abstract

“…According to the report, the proportion of liver cancer caused by hepatitis B is as high as 92.05% [ 6 ]. With the advancement of surgical treatment, radiotherapy, chemotherapy, immunotherapy, targeted therapy, and liver transplantation, the expected survival and quality of life of HCC patients were significantly improved [ 7 ]. However, since most patients with liver cancer have been in the middle-late stage at diagnosis and unable to accept surgery treatment, interventional treatment become one of the main treatment approaches for patients with liver cancer.…”

Section: Introductionmentioning

confidence: 99%

Construction and Validation of Prediction Model of Severe Abdominal Pain Post-Transarterial Chemoembolization in Patients with HBV-Associated Primary Liver Cancer

Yang

¹

,

Chen

²

,

Yan

³

et al. 2022

Computational and Mathematical Methods in Medicine

1

0

View full text Add to dashboard Cite

Objective. This study is aimed at constructing and evaluating a prediction model of severe abdominal pain post-transcatheter arterial chemoembolization in patients with HBV-related primary liver cancer. Methods. Patients with HBV-associated primary liver cancer who received transarterial chemoembolization (TACE) from March 2019 to March 2022 in the Interventional Therapy Department of our hospital were selected as the subjects, and the included 160 patients were randomly divided into modeling group ( n = 120 ) and validation group ( n = 40 ) in a ratio of 3 : 1. Visual analog scale (VAS) was used to assess pain severity. 120 patients in the modeling group were divided into no/mild abdominal pain group and severe abdominal pain group. The clinical data of the patients, including gender, age, TACE treatment history, vascular invasion, maximum diameter of tumor, infarction degree, preoperative Eastern Oncology Collaboration Group (ECOG) score, and Lipiodol dosage, were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the prediction model for severe abdominal pain post-TACE. Results. A total of 116 patients (72.50%) had severe abdominal pain after TACE. Univariate analysis showed that severe abdominal pain after TACE in the modeling group was associated with TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score (all P < 0.05 ), but not related to gender, age, vascular invasion, and Lipiodol dosage (all P > 0.05 ). Logistic regression analysis showed that TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score were all independent influencing factors for acute abdominal pain post-TACE in HBV-HCC patients (all P < 0.05 ). The prediction model equation was Y = − 3.673 + 1.722 × TACE treatment history + 1.175 × tumor maximum diameter + 2.064 × infarction degree + 1.555 × preoperative ECOG score . Goodness-of-fit test results showed no significant difference between the established prediction model and the observed value ( χ 2 = 1.645 , P = 0.560 ) and R 2 = 0.821 , suggesting that the prediction ability of the model was relatively accurate. ROC analysis results showed that the area under the curve (AUC) of severe abdominal pain after TACE was 0.916 (0.862~0.970) and 0.902 (95% CI: 0.841~0.963) in the modeling group and the verification group, respectively. Conclusion. TACE treatment history, tumor maximum diameter, infarction degree, and preoperative ECOG score are independent influencing factors for severe abdominal pain post-TACE in patients with HBV-HCC, and the prediction model established on this basis has good application value.

show abstract

Transarterial Chemoembolization for the Palliation of Painful Bone Metastases Refractory to First-Line Radiotherapy

Cited by 11 publications

References 29 publications

Efficacy and safety analysis of transarterial chemoembolization and transarterial radioembolization in advanced hepatocellular carcinoma descending hepatectomy

Efficacy and safety analysis of transarterial chemoembolization and transarterial radioembolization in advanced hepatocellular carcinoma descending hepatectomy

Interventional Management of Painful Vertebral Body Metastases

Construction and Validation of Prediction Model of Severe Abdominal Pain Post-Transarterial Chemoembolization in Patients with HBV-Associated Primary Liver Cancer

Contact Info

Product

Resources

About