Hepatic Arterial Chemoembolization Research Articles

A clinical study of targeted immunotherapy combined with hepatic arterial chemoembolization in the treatment of liver injury associated with primary liver cancer

Objective: To investigate the conditions of occurrence and factors influencing liver injury caused by molecular targeted drugs and immune checkpoint inhibitors combined with hepatic arterial chemoembolization (TACE) in the treatment of primary liver cancer. Methods: 105 cases of primary liver cancer admitted to the Third Hospital of Hebei Medical University from January 2020 to June 2023 were selected. Patients liver biochemical indicators conditional changes before and after treatment with targeted drugs+TACE and targeted drugs+immune checkpoint inhibitors (ICIs)+TACE were analyzed. Liver injuries above grade 2 and its independent risk factors to predict and evaluate model accuracy were established. Independent samples t-test, analysis of variance, and rank sum test were used for comparison of measurement data between groups. Count data were compared with a χ(2) test between groups. Results: A total of 50 (47.62%) of the 105 cases developed liver injury during the treatment course, with 26 (52%) cases of first-grade liver injury, 16 (32%) cases of second-grade liver injury, 8 (16%) cases of third-grade liver injury, and none of fourth-grade liver injury. There was no statistically significant difference in the incidence of liver injury between the two groups of patients (χ(2)=1.299, P = 0.637). Multivariate logistic regression analysis showed that total bilirubin, prealbumin, and prothrombin activity were independent risk factors for the occurrence of liver injury. The total bilirubin-prealbumin-prothrombin activity (TAP) model was established. TAP diagnosis of grade 2 or higher liver injury had an area under the receiver characteristic curve of 0.935, sensitivity of 84.35%, and specificity of 92.31% at a cut-off value of 1.24, and significantly better diagnostic performance than albumin-bilirubin (ALBI) grade. Conclusion: The occurrence of severe liver injury is minimal and well tolerated in the targeted drug + TACE treatment group and targeted drug + ICIs + TACE treatment group. The TAP model can be used as a new method to assess the risk of liver injury above grade 2 in patients treated with targeted immunotherapy combined with TACE.

Study on the comparison of postoperative liver injury caused by hepatic arterial perfusion chemotherapy combined with targeted immunotherapy with hepatic arterial chemoembolization combined with targeted immunotherapy for intermediate-and advanced-stage liver cancer

Objective: To compare the postoperative liver function injury condition in patients with intermediate-and advanced-stage hepatocellular carcinoma (HCC) treated with hepatic artery infusion chemotherapy (HAIC) and hepatic artery chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and multi-target tyrosine kinase inhibitors (TKIs). Methods: Patients with intermediate-and advanced-stage HCC who were admitted and treated with HAIC/TACE+ICIs+TKIs therapy at Nanfang Hospital of Southern Medical University from January 2019 to November 2021, with follow-up up to July 2023, were retrospectively enrolled. The results of liver function tests within one week before interventional surgery and on the first day after surgery were recorded. The degree of postoperative liver injury was graded according to the common terminology criteria for adverse events 5.0 (CTCAE 5.0). The treatment efficacy was evaluated according to RECIST 1.1 criteria. Measurement data were compared between groups using a t-test or a non-parametric rank sum test. Enumeration data were compared between the groups using the χ(2) test or Fisher's exact probability method. The survival condition differences were analyzed by the log-rank method. Results: This study included 82 and 77 cases in the HAIC and TACE groups. There were no statistically significant differences between the two groups of patients in terms of gender, age, physical condition score, number of tumors, presence or absence of liver cirrhosis, Child-Pugh grade, albumin-bilirubin (ALBI) grade, and combined ICIs and TKIs . The HAIC group had later tumor staging, a greater tumor burden, poorer liver reserve function, and a larger proportion of patients in stage C (81.7% vs. 63.6%), χ(2)=6.573, P = 0.01). There were 53 cases (64.6% vs. 32.5%) with a maximum tumor diameter of ≥ 10cm, χ(2)=16.441, P < 0.001), and more patients had a retention rate of ≥ 10% for indocyanine green (ICG) at 15 minutes (68.3% vs. 51.9%, P = 0.035). The postoperative incidence rate of increased levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin was significantly lower in the HAIC group than that in the TACE group (28.0% vs. 63.6%, χ(2)=20.298, P < 0.001, 54.9% vs. 85.7%, χ(2)=17.917, P < 0.001;40.2% vs. 55.8%, χ(2)=3.873, P = 0.049). The number of patients with postoperative ALBI grade 3 was significantly lower in the HAIC group than that in the TACE group (6.1% vs. 16.9%, χ(2)=4.601, P = 0.032). There was no statistically significant difference in the incidence rate of postoperative hypoalbuminemia, activated partial thromboplastin time, or increased international standardized ratio between the two groups of patients. There was no statistically significant difference in median progression-free survival (7.3 months vs. 8.2 months, P = 0.296) or median overall survival (16.5 months vs. 21.9 months, P = 0.678) between the two groups of patients. Conclusion: The incidence rate of postoperative liver injury is higher in patients with intermediate-and advanced-stage HCC treated with TACE combined with ICIs and TKIs than in patients with HAIC combined with ICIs and TKIs.

Application of transradial and transfemoral accesses during hepatic artery chemoembolization in the treatment of patients with malignant liver neoplasms

Introduction Malignant neoplasms of the liver are one of the most common pathologies in oncology. Chemoembolization of the hepatic artery is currently widely used in the treatment of unresectable liver tumors. Transradial vascular access is actively used in interventional cardiology due to fewer local vascular complications. At the same time, until recently, chemoembolization of the hepatic artery was more often performed via transfemoral vascular access.The aim of the work is a comparative analysis of the results of transradial and transfemoral vascular accesses for the purpose of hepatic artery chemoembolization.Material and methods The data of 69 patients who underwent 212 hepatic artery chemoembolization procedures for malignant neoplasms in the liver were analyzed. The group of transradial access included 107 (50.5 %) interventions, the group of transfemoral access – 105 (49.5 %). The groups were comparable in terms of the main initial clinical and anamnestic data.Results Chemoembolization of the hepatic artery was successfully performed in 98.1 % in the transradial access group and 99 % in the transfemoral access group (p = 1.0). The total duration of intervention, time spent on catheterization of the target artery and radiation exposure were significantly shorter in the transradial access group than in the opposite group. The incidence of local vascular complications was not significantly different between the groups: 11 (10.3 %) and 12 (11.4 %) cases, respectively (p = 0.79). According to the results of patient interviews, the use of transradial access was accompanied by significantly less discomfort associated with the procedure.Discussion Traditionally, embolization of peripheral arteries is performed via transfemoral access, and the total incidence of local vascular complications (large subcutaneous hematomas, false aneurysms, arterovenous fistulas, etc.) is relatively high. According to the results of studies, it is possible to reduce the incidence of local vascular complications without increasing the cost of the procedure by performing the same interventions using transradial access.Conclusion Transradial vascular access has a number of significant advantages over transfemoral access, and therefore can be recommended as a priority for performing hepatic artery chemoembolization.

Successful two-stage transplant hepatectomy using the ALPPS procedure for advanced hepatocellular cancer

In the presented case, after liver transplantation (LT) for hepatocellular cancer (HCC), the disease progressed in the graft, left lung and bronchopulmonary lymph nodes after 16 months, according to the Milan criteria. Against the background of combined treatment – hepatic artery chemoembolization (HAC), systemic targeted therapy and stereotactic radiotherapy for metastatic node of the left lung – HCC in the extrahepatic foci was stabilized. In this situation, we considered resection of the liver transplant as the only therapeutic option that provides a chance for significant prolongation of the patient’s life. However, extensive resection of the right liver lobe seemed unsafe due to a number of limiting factors – borderline functional residual capacity of the remaining liver: future liver remnant (FLR), 599 cm3 (32%); plasma disappearance rate (PDR), 12.3%/min; tumor invasion of the middle hepatic vein basin. In this case, right portal vein branch (RPVB) embolization could promote vicarious hypertrophy of the remaining part of the liver, but the waiting period usually exceeds three to four weeks, and the RPVB was already partially blocked by the tumor at that time. The only option for surgical intervention was, in our opinion, two-stage hepatectomy according to the Associated Liver Partition and Portal Vein Ligation for Staged hepatectomy (ALPPS) procedure, despite the absence of literature data on the performance of such operations on a liver transplant. On postoperative day 5 from the first stage, a 799 cm3 FLR hypertrophy was achieved, which allowed to perform the second stage of intervention relatively safely. Competent tactics regarding medication in the intensive care unit (ICU) and renal replacement therapy allowed to cope with sepsis and acute renal failure – the prevailing postoperative complications.

Gastrointestinal Stromal Tumor (GIST)

&#x0D; &#x0D; &#x0D; Gastrointestinal stromal tumor (GIST) are the most common mesenchymal tumor of the gastrointestinal tract and most common malignancy of the small intestine. Although the exact prevalence of GIST is not known, GIST was recognized as tumor it's arise from interstitial cells of Cajal. Most of the GISTs driven by a KIT or platelet-derived growth factor receptor alpha (PDGFRA) mutation. Histologically, GISTs look like spindle cell tumors most of the time, but they can be epitheoid or mixed type. Clinically, patients with small GISTs remain asymptomatic. In another case, patients with larger GISTs present with various symptoms depending on the location of the GISTs. Most of GISTs are located in the stomach or small bowel. But, they can involve almost any segment of the gastrointestinal tract from distal esophagus to anus. Diagnosis is suspected on imaging and endoscopic studies, and confirmed by tissue acquisition with immunohistochemical staining. The various endoscopic modalities of resection are increasingly tried. Surgical resection is the treatment of choice. In management of larger GISTs, tyrosine kinase inhibitors are extremly useful. Treatment options for metastatic GISTs also include radiotherapy, chemotherapy, hepatic artery embolization, chemoembolization, and radiofrequency ablation.&#x0D; &#x0D; &#x0D;

The Long Non-Coding RNA AC006329.1 Facilitates Hepatocellular Carcinoma Progression and Metastasis by Regulating miR-127-5p/SHC3/ERK Axis.

Hepatocellular carcinoma(HCC) is the most common type of liver cancer and the sixth largest common cancer worldwide. Although surgical resection, hepatic arterial chemoembolization, targeted drugs and immunotherapy are currently available, the mortality of advanced patients remains high. Therefore, new therapeutic targets are urgently needed. In recent years, many studies have found that The long non-coding RNA(lncRNA) has multiple functions in human tumors, including participating in epigenetic, transcriptional, post-transcriptional and translational regulation, and is closely related to the progression of HCC. The purpose of this study was to investigate the role of AC006329.1 in HCC progression and provide theoretical guidance for finding new targets. AC006329.1 was screened out by transcriptome sequencing and quantitative real-time polymerase chain reaction (qRT-PCR). Then a series of functional tests in vivo and in vitro were conducted to investigate the effects of AC006329.1 on HCC progression and metastasis. Epithelial-mesenchymal transformation (EMT) of HCC was detected by Western blot and immunofluorescence staining. The targeted miRNA and downstream gene of AC006329.1 were predicted by databases and the pathway regulation axis eventually validated by dualluciferasereporterassays, qRT-PCR and WB. AC006329.1 was found high expressed in HCC tissues and cell lines by qRT-PCR. The prognosis of HCC patients with high expressed AC006329.1 was poor. In vitro and in vivo, overexpression of AC006329.1 can promote the progression, metastasis and EMT of HCC by acting as a sponge of miR-127-5p to increase the expression of SHC3. In addition, up-regulation of miR-127-5p or knockdown of SHC3 can both reverse the promoting effects of AC006329.1 on progression, metastasis and EMT of HCC. Finally, WB and qRT-PCR analysis was discovered that AC006329.1 can facilitate HCC progression, EMT and metastasis by competitively inhibiting miR-127-5p to activate SHC3/ERK signaling pathway. These above experimental results confirmed that AC006329.1 can facilitate HCC progression, EMT and metastasis by acting as a competing endogenous RNA (ceRNA) to inhibit miR-127-5p and activate SHC3/ERK signaling pathway.

Construction of pain prediction model for patients undergoing hepatic arterial chemoembolization

ObjectiveTo construct a predictive model for pain in patients undergoing hepatic arterial chemoembolization (TACE) in interventional operating room.MethodsThrough literature review and expert interviews, a questionnaire was prepared for the assessment of pain factors in patients with hepatic arterial chemoembolization. A prospective cohort study was used to select 228 patients with hepatic arterial chemoembolization in a tertiary and first-class hospital. The data of the patients in the pain group and the non-pain group were compared, and a rapid screening prediction model was constructed by univariate analysis and logistic regression analysis, and its prediction effect was tested.ResultsTumor size, liver cancer stage, and chemoembolization with drug-loaded microspheres and pirarubicin hydrochloride (THP) mixed with lipiodol were independent predictors of pain in patients after hepatic arterial chemoembolization. Finally, the pain prediction model after TACE was obtained. The results of Hosmer–Lemeshow test showed that the model fit was good (χ2 = 13.540, p = 0.095). The area under the receiver operating characteristic curve was 0.798, p < 0.001.ConclusionThe rapid screening and prediction model of pain in patients undergoing hepatic arterial chemoembolization has certain efficacy, which is helpful for clinical screening of patients with high risk of pain, and can provide reference for predictive pain management decision-making.

Effect of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation on Liver Function and Immune Function in Patients with Hepatocellular Carcinoma.

Objectives To investigate the effects of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) on liver function and immune function in patients with hepatocellular carcinoma (HCC). Methods From December 2016 to January 2019, patients with primary liver cancer who could not be operated on were selected as the study subjects. 170 patients were randomly divided into two groups. The control group was treated with transcatheter arterial chemoembolization (n = 85). The patients in the observation group were treated with transcatheter arterial chemoembolization combined with radiofrequency ablation (n = 85). The clinical effects of the two groups were analyzed. The changes of liver function and immune function were detected by automatic biochemical analyzer before and after treatment. The changes of hypoxia inducible factor-1 (HIF1) alpha and vascular endothelial growth factor (VEGF) levels before and after treatment were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The total effective rate in the observation group was significantly higher than that in the control group (P < 0.05). After treatment, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), CD8+, HIF1 alpha, and VEGF decreased significantly (P < 0.05), while levels of total bilirubin, direct bilirubin, indirect bilirubin, CD3+, CD4+, and CD4+/CD8+ increased significantly (P < 0.05). The changes of the above indexes in the observation group were more significant than those in the control group (P < 0.05). Conclusion Hepatic arterial chemoembolization combined with radiofrequency ablation has a significant effect on liver function and immune function in patients with liver cancer, which may be related to the abnormal levels of HIF1α and vascular endothelial growth factor.

Effects of preoperative serum lactate dehydrogenase levels on long-term prognosis in elderly patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.

Hepatic arterial chemoembolization is an effective treatment for primary hepatocellular carcinoma (HCC) and can improve the survival rate of patients. Nevertheless, the long-term prognosis of patients with HCC is not optimistic. In recent years, tumor humoral detection has attracted extensive attention and is expected to become the main examination method for early tumor screening. Studies have found that serum LDH is an indicator with effective potential to predict tumor proliferation and progression, such as pancreatic cancer, esophageal cancer, nasopharyngeal cancer, etc., but the relationship between this indicator and the prognosis of HCC is still unclear. The purpose of this study was to clarify the relationship between serum LDH and the prognosis of patients with HCC, so as to provide an important scientific basis for prognosis judgment of HCC.

Hepatocellular cancer. Current trends and the results in surgical treatment

Aim. To analyze the results of a multidisciplinary approach to the treatment of patients with hepatocellular cancer in a multidisciplinary oncology clinic.Materials and Methods. From 2007 to 2021, 259 patients with hepatocellular cancer were surgically treated in the Department of Liver and Pancreas Surgery of the city clinical hospital named after S.P. Botkin. Liver resections of different extent were performed in 74 (28.6%) patients, radiofrequency ablation – in 19 (7.3%), microwave ablation – in 20 (7.7%), hepatic artery chemoembolization with radiofrequency ablation – in 34 (13.1%), regional chemotherapy – in 104 (40.2%), liver transplantation – in 8 (3.1%) patients.Results. The overall five- and ten-year survival after liver resection was 51.4% and 31.1% respectively. The poor prognostic factors following liver resection were age &gt;70 years (p = 0.03), postoperative complications (p = 0.04), lymph node metastases (p = 0.01), and a body mass index &gt;30 kg/m2 (p = 0.045). Complications that developed after radiofrequency (microwave) ablation and chemoembolization of the hepatic artery with radiofrequency ablation were 5.1% and 5.8%. Within 90 days after liver resection, three (1.1%) patients died. Complications after resection developed in 18 (24.3%) cases during the same period. With metastases measuring ≤3 cm, the overall five-year survival after radiofrequency and microwave ablation was 36.8% and 35% respectively. With neoplasms measuring 3–5 cm, the best five-year survival was after hepatic artery chemoembolization and radiofrequency ablation (44.1%). The overall fiveyear survival after hepatic artery chemoembolization was 11.5%. No complications or deaths resulted from liver transplantation. With an average follow-up period of 12.5 months, none of the patients experienced disease recurrence or died.Conclusion. Using a multidisciplinary approach in a multidisciplinary oncology clinic improves the results of treating patients with hepatocellular cancer.

Efficacy of Lipid Nanoparticle-Loaded Sorafenib Combined with Hepatic Artery Chemoembolization in the Treatment of Primary Hepatocellular Carcinoma Complicated with Microvascular Invasion.

This work was to evaluate the therapeutic effect of lipid nanoparticle-loaded sorafenib combined with transcatheter artery chemoembolization (TACE) in patients with primary hepatocellular carcinoma (HC) complicated with microvascular invasion (MVI). In this work, 102 patients with primary HC combined with MVI after radical resection were divided into 4 groups according to different treatment methods. Experimental group 1 was treated with lipid nanoparticle-loaded sorafenib combined with TACE treatment group; experimental group 2 was treated with lipid nanoparticle-loaded sorafenib treatment group; experimental group 3 was TACE treatment group; control group was postoperative routine nursing group. Sorafenib lipid nanoparticles were prepared. The basic information, operation, MVI degree, tumor recurrence, and survival time of patients in each group were recorded and compared to evaluate the therapeutic effect of combined way. No great difference was found in MVI grade, average age, sex ratio, preoperative tumor markers, tumor size, number of patients with liver cirrhosis, operation time, and intraoperative bleeding among the four groups (P > 0.05). In addition, the tumor free survival time (TFST), overall survival time (OST), and postoperative 1-year and 2-year survival rates of patients in test group 1 were greatly higher than those in single mode treatment group and control group (P < 0.05). In summary, sorafenib nanoparticles combined with TACE can improve the survival status of patients after resection and delay the time of postoperative tumor recurrence.

Treatment outcomes among patients with metastatic uveal melanoma: a retrospective monocentric study

Aim: to establish the dependence of cancer specific survival rate of patients with metastatic uveal melanoma on the treatment method, according to the Belarusian Cancer Registry. Material and methods. We analyzed the data of the Belarusian cancer registry and medical records of patients diagnosed with metastatic uveal melanoma in the period from 2006 to 2015. Treatment methods included chemotherapy, radiation therapy, surgical removal of metastases, immunotherapy with roncoleukin. Hepatotropic therapy included hepatic artery chemoembolization, radiofrequency ablation of metastatic foci, or liver resection. We analyzed cancer specific 1-, 3-, 5- and 10-year survival of patients in treatment groups. Results. The median cancer specific survival of patients who received only supportive care was 2.0 (95% CI 1.1–2.9) months, after any of the anticancer therapy methods application — 10.0 (95% CI 7.3–12.7) months. The median cancer specific survival in the chemotherapy group was 9.0 (95% CI 6.3–11.7) months, in the case of hepatotropic therapy — 20.0 (95% CI 10.9–29.1). The median cancer specific survival of patients receiving immunotherapy was 7.0 (95% CI 1.1–12.9), the survival plateau was reached after 48 months. Conclusion. Metastatic uveal melanoma is characterized by a poor prognosis, including during therapy. Both hepatotropic and systemic therapy have limited efficacy. Further study of the tumor biology and immune microenvironment is required in order to determine possible targets of exposure.

Effects of image-guided adaptive radiotherapy combined with hepatic artery chemoembolization in primary liver cancer patients

ObjectiveThe study aimed to explore the effects of image-guided adaptive radiotherapy combined with hepatic artery chemoembolization on the immune function of primary liver cancer patients. MethodsThe study included 84 primary liver cancer patients who received treatment at our hospital between April 2018 and January 2020. They were divided into the control group (n=42, hepatic artery chemoembolization) and the study group (n=42, image-guided adaptive radiotherapy combined with hepatic artery chemoembolization) using the random number table method. AFP, ALT, AST, CA724, CA242 and immune function before and after treatment were compared in the two groups and the short-term efficacy and adverse events (AEs) were statistically analyzed. The two groups were followed up. ResultsAfter treatment, the study group had a higher ORR and DCR compared to the control group, and the difference was statistically significant (P < 0.05). There was no statistical difference in the levels of AFP, ALT, AST, CA724 and CA242 between the two groups before treatment (P > 05). After treatment, the study group had lower levels of AFP, ALT, AST, CA724 and CA242 than the control group, and the difference was statistically significant (P < 0.05). There was no statistical difference in the levels of CD4+, CD8+, and CD4+/CD8+ before treatment in the two groups (P > 05). After treatment, the study group had higher levels of CD4+ and CD4+/CD8+ but lower levels of CD8+ compared to the control group, and the difference was statistically significant (P < 0.05). In the study group, 2 patients developed radiation-induced liver disease, and the incidence was 4.76% (2/42), which occurred at 4 and 6 weeks after the end of radiotherapy, respectively. The patients mainly had elevated transaminases, ascites, and liver enlargement and hepatoprotection and nutritional support were provided, and the patients gradually recovered after treatment. There was no statistical difference in the incidence of AEs between the two groups (p > 0.05). All patients in the study completed follow up and the follow up completion rate was 100%. The median duration of follow up was 22.5 months. In the study group, 12 of 42 patients (28.57%) died and 21 cases (50.00%) had recurrence. In the control group, 21 of 42 cases (50.00%) died and 27 cases (64.29%) recurred. At 1 year, there was no statistical difference in ORR and DCR between the two groups (P > 0.05) and at 2 years, the study group had a higher ORR and DCR than the control group, and the difference was statistically significant (P < 0.05). ConclusionImage-guided adaptive radiotherapy combined with hepatic artery chemoembolization may improve the immune function of primary liver cancer patients and is of important clinical application value.

LUKOIL lets contracts for Perm refinery's proposed FCC complex

Pancreatic neuroendocrine tumors (PNETs) were formerly termed pancreatic islet tumors. These are rare tumors, comprising 2%–3% of all pancreatic tumors. They derive from pluripotent pancreatic stem cells. PNETs can be classified as functional and nonfunctional. Functional tumors secrete hormones that result in a specific clinical presentation. Insulinomas are the most common PNETs. They are usually benign. Glucagonomas and VIPoma are most commonly malignant. Surgical resection, surgical debulking ± systemic treatment may be used. The Zollinger-Ellison syndrome (ZES) is characterized by gastric acid hypersecretion leading to severe acid-related peptic ulcer disease with diarrhea, caused by a gastrinoma, also a neuroendocrine tumor. The gastrinoma triangle (sweep of duodenum/head of pancreas) is the location of 80% of these tumors. The majority of gastrinomas are located in the duodenum. Gastrinomas may be associated with MEN1 (hyperparathyroidism, pituitary tumors, and gastrinoma) in 20% of cases. Surgical resection is the primary treatment of choice for sporadic gastrinoma. Enucleation of small pancreatic tumors, duodenotomy, and enucleation of small duodenal tumors are the most common procedures performed. Liver resection, hepatic artery embolization and/or chemoembolization, microsphere embolization, radiofrequency or cryoablation, and liver transplantation all have been utilized for metastatic disease.

Superparamagnetic Iron Oxide Nanoparticles (SPIONs) Loaded with miR-29a Improve Efficacy of Chemotherapy in Hepatocellular Carcinoma

Development of hepatic artery chemoembolization technology effectively improves outcome of hepatocellular carcinoma (HCC), but it is still not the first-line option. This study aimed to explore therapeutic potential of superparamagnetic iron oxide nanoparticles (SPIONs) in the treatment of HCC. After establishment of miR-29aloaded SPIONs, HCC cells were co-cultured with composite nanoparticles or infected with lentivirus expressing miR-29a, and then exposed to X-ray at a dose of 0.2 Gy/day. MTT, flow cytometry and colony formation experiments were carried out to determine proliferation, apoptosis and colony forming ability of HCC cells. Animal experiments were set up through hepatic artery perfusion to assess the in vivo effect of miR-29aloaded SPIONs on tumor growth. Both miR-29a-loaded SPIONs and miR-29a-loaded nanoparticles decreased proliferation and migration of HCC cells, enhancing sensitivity of cells to chemotherapy, whilst SPIONs exhibited more significant effect and significantly suppressed tumor growth. The presence of SPIONs decreased clone formation and hindered cell cycle progression of HCC cells. This study confirmed that miR-29a-loaded SPIONs suppress malignant characteristics of HCC cells and sensitize cells to chemotherapy, improving the efficacy of treatment, which provides a potential alternative for targeted chemotherapy of HCC.

CHEMOEMBOLIZATION OF THE HEPATIC ARTERY IN THE TREATMENT OF PATIENTS WITH CHEMORESISTANT METASTASES OF COLORECTAL CANCER. REVIEW

In the structure of the incidence of malignant tumors for a number of years, colorectal cancer occupies one of the leading positions, with a steady tendency to growth. The five-year survival rate of patients with metastatic liver damage in colorectal cancer does not exceed 28%. A significant breakthrough in the study of the biology of colorectal cancer has led to a deep understanding of individual processes of carcinogenesis and a personalized approach to treatment tactics. Despite this, the problem of chemoresistance remains one of the most acute. The high toxicity of systemic chemotherapy limits its use in this group of patients. In this connection, minimally invasive and at the same time effective methods of local treatment of malignant liver tumors have been introduced into clinical practice. These methods include: hepatic artery chemoinfusion, chemoembolization, oil chemoembolization and radioembolization. At present, a large world experience has already been accumulated in the application of the above-described methods of treatment. However, the question of the application of methods of interventional surgery in the treatment of patients with chemoresistant metastases is still open. The presented review reflects the results of the analysis of scientific literature on the treatment of this group of patients. The main stages of development and improvement of X-ray endovascular methods of treatment are presented.

Role of N6-Methyladenosine (m6A) Methylation Regulators in Hepatocellular Carcinoma.

Liver cancer is the fifth most common malignant tumor in terms of incidence and the third leading cause of cancer-related mortality globally. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Although great progress has been made in surgical techniques, hepatic artery chemoembolization, molecular targeting and immunotherapy, the prognosis of liver cancer patients remains very poor. N6-methyladenosine (m6A) is the most abundant internal RNA modification in eukaryotic cells and regulates various stages of the RNA life cycle. Many studies have reported that the abnormal expression of m6A-related regulators in HCC represent diagnostic and prognostic markers and potential therapeutic targets. In this review, firstly, we introduce the latest research on m6A-related regulators in detail. Next, we summarize the mechanism of each regulator in the pathogenesis and progression of HCC. Finally, we summarize the potential diagnostic, prognostic and therapeutic value of the regulators currently reported in HCC.

Radioembolization Versus Bland or Chemoembolization for Liver-Dominant Neuroendocrine Tumors: Is it an Either/Or Question?

Hepatic arterial embolization has been used for decades to treat liver-dominant metastatic neuroendocrine tumors (NETs). During the 1970s–1990s, transarterial bland hepatic arterial embolization (TAE) and chemoembolization (TACE) techniques were developed ([ 1 ][1],[ 2 ][2]). Numerous studies have

Usefulness of a novel transarterial chemoinfusion plus external-beam radiation therapy for advanced hepatocellular carcinoma with tumor thrombi in the inferior vena cava and right atrium: Case study.

BackgroundInvasion beyond inferior vena cava (IVC) to right atrium (RA) is a rare complication in patients with advanced hepatocellular carcinoma (HCC), and results in fatal oncologic emergencies, including pulmonary embolism and right heart failure.AimAs there is no gold standard treatment for unresectable HCC with tumor thrombi involving IVC and RA, we considered it valuable to assess safety and efficacy of a combination of hepatic arterial infusion chemoembolization (HAIC) therapy and external‐beam radiation therapy (EBRT).Methods and resultsThe “New FP” was chosen as the HAIC therapy, in which the enhanced permeation and retention effect was achieved using a cisplatin‐Lipiodol suspension combined with continuous infusion of 5‐fluorouracil (5‐FU). Sixteen patients with HCC with tumor thrombi in IVC, RA, and pulmonary arteries were enrolled. modified response evaluation criteria in solid tumors‐based evaluation of response to the combination treatment was as follows: complete response, 6.2% (1 patient); partial response, 81.3% (13 patients); stable disease, 12.5% (2 patients); progressive disease, 0%. The median overall survival time (MST) was 19.0 months. Notably, MST of patients receiving sequential sorafenib monotherapy (39.0 months) was significantly longer than that of the rest (15.3 months).ConclusionThe combination of New FP and EBRT is an efficacious treatment option for unresectable HCC involving IVC and RA, complicated with pulmonary embolism. Sequential administration of molecular‐targeted drugs may prolong survival in such patients.

Clinical application of gelatin sponge microparticles combined with pirarubicin for hepatic transcatheter arterial chemoembolization in breast cancer liver metastasis treatment: results of a single-center long-term study

ObjectiveTo retrospectively analyze the safety and long-term clinical efficacy of gelatin sponge microparticles combined with the chemotherapy drug pirarubicin for hepatic transcatheter arterial chemoembolization (GSMs-TACE) in order to treat breast cancer liver metastasis (BCLM).MethodsTwenty-seven BCLM patients who underwent GSMs-TACE from July 2010 to July 2016 were enrolled. Tumor target blood vessels were slowly and regionally embolized with absorbable gelatin sponge particles and pirarubicin injections. Plain computed tomography (CT) scans and biochemical indexes were re-examined at 4 days after treatment, and enhanced CT scans or magnetic resonance images and biochemical indexes, 1 month later. For patients with stable tumors, the follow-up period was 2 to 3 months, and the tumor response was evaluated using Modified Response Evaluation Criteria in Solid Tumors. Adverse reactions, survival time, and prognostic factors were assessed.ResultsBy October 2019, 27 patients with BCLM had undergone GSMs-TACE, with an average of 2.44 ± 1.58 treatments. The 1-, 3-, and 5-year survival rates were 62.96%, 22.22%, and 14.81%, respectively, and the mOS was 22.0 months. No serious complications, such as acute liver failure and liver abscess, had occurred. There were two cases of acute cholecystitis that recovered after symptomatic treatment. Multivariate analysis of the prognosis showed that the primary tumor size, number of metastatic lymph nodes, estrogen receptor/progesterone receptor (ER/PR) status, and time to postoperative liver metastasis and combination therapy were statistically significant.ConclusionsThe overall prognosis of BCLM was poor. GSMs-TACE was safe and effective for BCLM treatment and could prolong the median survival time of patients. Therefore, it is worthy of widespread clinical application.