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Significant efficacy and well safety of apatinib in an advanced liver cancer patient: a case report and literature review.
Kou, P, Zhang, Y, Shao, W, Zhu, H, Zhang, J, Wang, H, Kong, L, Yu, J
Oncotarget. 2017;(12):20510-20515
Abstract
Apatinib is a novel and highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2. Previous studies have suggested that apatinib is safe and effective in some solid tumors. We report one case with advanced hepatocellular carcinoma (HCC), who received apatinib combined with transhepatic arterial chemotherapy and embolization (TACE), and chemotherapy respectively. TACE was administered three times once a month, using lipiodol 10ml, oxaliplatin 150mg, and tegafur 1g. The dose of apatinib was 500 mg/d from day 4 to 24. After TACE, the patient received chemotherapy of regimen FOLFOX4, oxaliplatin intravenously at 85 mg/m2 on day 1, calcium levofolinate 200 mg/m2 on day 1 and 2, 5-fluorouracil 400 mg/m2 intravenously and 5-fluorouracil 600 mg/m2 intravenously pumped for 22h on day 1 and 2, cycled every two weeks for seven cycles. He took concurrently apatinib with a dose of 500mg daily from 1 to 10 days per cycle. He was confirmed as partial response (PR) by the Response Evaluation Criteria in Solid Tumors (RECIST). The level of serum alpha-fetoprotein (AFP) decreased from 60500 ng/ml to 12.7 ng/ml, and the progression free survival (PFS) time was more than eight months. It indicated that apatinib may be a superior choice for HCC patients.
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Numerical simulations on conformable laser-induced interstitial thermotherapy through combined use of multi-beam heating and biodegradable nanoparticles.
Zhang, J, Jin, C, He, ZZ, Liu, J
Lasers in medical science. 2014;(4):1505-16
Abstract
Clinically, precisely heating and thus completely ablating diseased tumor tissue through laser beam is still facing many technical challenges. In this study, numerical simulation of a conformal heating modality based on multi-beam laser along with biodegradable magnesium nanoparticles (Mg-NPs) was put forward to treat liver tumor with large size or irregular shape. Further, a Gaussian-like distribution was proposed to investigate the influence of Mg-NP deposition on the nanoenhanced laser-induced interstitial thermotherapy (LITT). A temperature feedback system was adopted to control the temperature range to avoid overheating. To preliminarily validate the heating enhancement induced by the applied multi-beam laser and Mg-NPs, a conceptual experiment was performed. Both theoretical simulation and experimental measurements demonstrated that multi-beam laser with Mg-NPs could improve efficiency in the conformal heating of tumors with irregular shape or large size. In addition, the distribution and content of Mg-NPs produced significant impact on thermotherapy: (1) The adjustable parameter σ in the Gaussian-like distribution could reflect various practical situations and diffusivities of Mg-NPs; (2) under the premise of the same concentration of Mg-NPs and short time to heat a small-sized target, the whole liver tumor containing Mg-NPs could not improve the efficiency as the nanoparticles limited the photons to be absorbed only around the fibers, while liver tumor partially containing Mg-NPs could improve the thermotherapy efficiency up to 20 %; and (3) the addition of Mg-NPs was rather beneficial for realizing a conformal heating as the residual thermal energy was much less than that without Mg-NPs. This study suggests a feasible and promising modality for planning a high-performance LITT in future clinics.
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Associations between methylenetetrahydrofolate reductase polymorphisms and hepatocellular carcinoma risk in Chinese population.
Qi, X, Sun, X, Xu, J, Wang, Z, Zhang, J, Peng, Z
Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. 2014;(3):1757-62
Abstract
Genetic polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene are considered to have some influence on both folate metabolism and cancer risk. Previous studies on the associations of MTHFR genetic polymorphisms with hepatocellular carcinoma (HCC) risk in Chinese population reported inconsistent results. We performed this meta-analysis to comprehensively assess the associations. Finally, 12 individual case-control studies were included into the meta-analysis. There were seven studies (6,384 subjects) on the MTHFR C677T polymorphism and five studies (4,502 subjects) on the MTHFR A1298C polymorphism. Overall, MTHFR C677T polymorphism was significantly associated with susceptibility to HCC in Chinese population (T versus C, odds ratio (OR) = 1.09, 95 % confidence interval (95% CI) 1.01-1.17; TT versus CC, OR = 1.17, 95% CI 1.00-1.38; TT/CT versus CC, OR = 1.12, 95% CI 1.00-1.26). MTHFR A1298C polymorphism was conversely associated with HCC risk in Chinese population (CC versus AA, OR = 0.65, 95% CI 0.46-0.91; CC versus AA/AC, OR = 0.64, 95% CI 0.46-0.90). The sensitivity analysis confirmed the reliability and stability of the meta-analysis. Thus, the findings from our meta-analysis support the associations of MTHFR C677T and A1298C polymorphisms with HCC risk in Chinese population.
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Clinical value of contrast-enhanced ultrasonography in the characterization of focal liver lesions: a prospective multicenter trial.
Wang, WP, Wu, Y, Luo, Y, Li, R, Zhou, XD, Zhang, J, Qian, CW, Tan, XY, Xu, QH, Wang, Y, et al
Hepatobiliary & pancreatic diseases international : HBPD INT. 2009;(4):370-6
Abstract
BACKGROUND Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the characterization of FLLs in comparison with final diagnosis based on gold standard assessment. METHODS The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue, Bracco, Italy). Sensitivity, specificity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue enhanced US examination. Sensitivity and specificity improved from 49% and 25% at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION SonoVue enhanced US improves the characterization of FLLs and may limit the need for further investigations.