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Cancers
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Advances of Locoregional Therapy for Hepatocellular Carcinoma
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Advances of Locoregional Therapy for Hepatocellular Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (1 March 2021) | Viewed by 10091

Special Issue Editor

Dr. Toru Ishikawa

E-Mail Website
Guest Editor
Department of Gastroenterology and Hepatology, Saiseikai Niigata Hospital, Niigata, Japan
Interests: interventional radiology; hepatocellular carcinoma; portal hypertension

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is associated with high rates of mortality and recurrence. Its incidence remains high due to the persistent prevalence of viral hepatitis, alcoholic cirrhosis, and non-alcoholic fatty liver disease (NAFLD). However, the majority of patients will present with advanced disease without strict screening efforts. Early detection of hepatocellular carcinoma may even prevent intrahepatic and/or extrahepatic recurrence.

The discovery of multiple tyrosine kinase inhibitors (TKIs) led to the approval of the first efficacious therapy for the advanced stage of HCC. A new era in the treatment paradigm for HCC is emerging. Hence, combinations of local and systemic therapies are actively being investigated as an option for the treatment of locally advanced disease, which has conventionally been treated with locoregional approaches, such as transcatheter arterial chemoembolization (TACE) and ablation therapy. The prospects remain promising and continue to evolve for HCC, a disease for whom those affected have long been considered to have unmet needs.

This Special Issue aims to highlight the current state of the art in strategies for the treatment of HCC from both the basic and clinical perspectives, and outline future prospects for improving therapies.

Dr. Toru Ishikawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hepatocellular carcinoma
  • locoregional therapy
  • ablation
  • transcatheter arterial chemoembolization

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Published Papers (3 papers)

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Research

17 pages, 2073 KiB  
Article
For Hepatocellular Carcinoma Treated with Yttrium-90 Microspheres, Dose Volumetrics on Post-Treatment Bremsstrahlung SPECT/CT Predict Clinical Outcomes
by Crystal Seldon Taswell, Matthew Studenski, Thomas Pennix, Bryan Stover, Mike Georgiou, Shree Venkat, Patricia Jones, Joseph Zikria, Lindsay Thornton, Raphael Yechieli, Prasoon Mohan, Lorraine Portelance and Benjamin Spieler
Cancers 2023, 15(3), 645; https://doi.org/10.3390/cancers15030645 - 20 Jan 2023
Cited by 8 | Viewed by 3549
Abstract
In transarterial radioembolization (TARE) of hepatocellular carcinoma (HCC) with Yttrium-90 (Y-90) microspheres, recent studies correlate dosimetry from bremsstrahlung single photon emission tomography (SPECT/CT) with treatment outcomes; however, these studies focus on measures of central tendency rather than volumetric coverage metrics commonly used in [...] Read more.
In transarterial radioembolization (TARE) of hepatocellular carcinoma (HCC) with Yttrium-90 (Y-90) microspheres, recent studies correlate dosimetry from bremsstrahlung single photon emission tomography (SPECT/CT) with treatment outcomes; however, these studies focus on measures of central tendency rather than volumetric coverage metrics commonly used in radiation oncology. We hypothesized that three-dimensional (3D) isodose coverage of gross tumor volume (GTV) is the driving factor in HCC treatment response to TARE and is best assessed using advanced dosimetry techniques applied to nuclear imaging of actual Y-90 biodistribution. We reviewed 51 lobar TARE Y-90 treatments of 43 HCC patients. Dose prescriptions were 120 Gy for TheraSpheres and 85 Gy for SIR-Spheres. All patients underwent post-TARE Y-90 bremsstrahlung SPECT/CT imaging. Commercial software was used to contour gross tumor volume (GTV) and liver on post-TARE SPECT/CT. Y-90 dose distributions were calculated using the Local Deposition Model based on post-TARE SPECT/CT activity maps. Median gross tumor volume (GTV) dose; GTV receiving less than 100 Gy, 70 Gy and 50 Gy; minimum dose covering the hottest 70%, 95%, and 98% of the GTV (D70, D95, D98); mean dose to nontumorous liver, and disease burden (GTV/liver volume) were obtained. Clinical outcomes were collected for all patients by chart and imaging review. HCC treatment response was assessed according to the modified response criteria in solid tumors (mRECIST) guidelines. Kaplan-Meier (KM) survival estimates and multivariate regression analyses (MVA) were performed using STATA. Median survival was 22.5 months for patients achieving objective response (OR) in targeted lesions (complete response (CR) or partial response (PR) per mRECIST) vs. 7.6 months for non-responders (NR, stable disease or disease progression per mRECIST). On MVA, the volume of underdosed tumor (GTV receiving less than 100 Gy) was the only significant dosimetric predictor for CR (p = 0.0004) and overall survival (OS, p = 0.003). All targets with less than CR (n = 39) had more than 20 cc of underdosed tumor. D70 (p = 0.038) correlated with OR, with mean D70 of 95 Gy for responders and 60 Gy for non-responders (p = 0.042). On MVA, mean dose to nontumorous liver trended toward significant association with grade 3+ toxicity (p = 0.09) and correlated with delivered activity (p < 0.001) and burden of disease (p = 0.05). Dosimetric models supplied area under the curve estimates of > 0.80 predicting CR, OR, and ≥grade 3 acute toxicity. Dosimetric parameters derived from the retrospective analysis of post-TARE Y-90 bremsstrahlung SPECT/CT after lobar treatment of HCC suggest that volumetric coverage of GTV, not a high mean or median dose, is the driving factor in treatment response and that this is best assessed through the analysis of actual Y-90 biodistribution. Full article
(This article belongs to the Special Issue Advances of Locoregional Therapy for Hepatocellular Carcinoma)
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13 pages, 998 KiB  
Article
Comparing the Safety and Efficacy of Microwave Ablation Using ThermosphereTM Technology versus Radiofrequency Ablation for Hepatocellular Carcinoma: A Propensity Score-Matched Analysis
by Hidekatsu Kuroda, Tomoaki Nagasawa, Yudai Fujiwara, Hiroki Sato, Tamami Abe, Yohei Kooka, Kei Endo, Takayoshi Oikawa, Kei Sawara and Yasuhiro Takikawa
Cancers 2021, 13(6), 1295; https://doi.org/10.3390/cancers13061295 - 15 Mar 2021
Cited by 14 | Viewed by 2902
Abstract
There is limited information regarding the oncological benefits of microwave ablation using ThermosphereTM technology for hepatocellular carcinoma. This study compared the overall survival and recurrence-free survival outcomes among patients with hepatocellular carcinoma after microwave ablation using ThermosphereTM technology and after radiofrequency [...] Read more.
There is limited information regarding the oncological benefits of microwave ablation using ThermosphereTM technology for hepatocellular carcinoma. This study compared the overall survival and recurrence-free survival outcomes among patients with hepatocellular carcinoma after microwave ablation using ThermosphereTM technology and after radiofrequency ablation. Between December 2017 and August 2020, 410 patients with hepatocellular carcinoma (a single lesion that was ≤5 cm or ≤3 lesions that were ≤3 cm) underwent ablation at our institution. Propensity score matching identified 150 matched pairs of patients with well-balanced characteristics. The microwave ablation and radiofrequency ablation groups had similar overall survival rates at 1 year (99.3% vs. 98.2%) and at 2 years (88.4% vs. 87.5%) (p = 0.728), as well as similar recurrence-free survival rates at 1 year (81.1% vs. 76.2%) and at 2 years (60.5% vs. 62.1%) (p = 0.492). However, the microwave ablation group had a significantly lower mean number of total insertions (1.22 ± 0.49 vs. 1.59 ± 0.94; p < 0.0001). This retrospective study revealed no significant differences in the overall survival and recurrence-free survival outcomes after microwave ablation or radiofrequency ablation. However, we recommend microwave ablation for hepatocellular carcinoma tumors with a diameter of >2 cm based on the lower number of insertions. Full article
(This article belongs to the Special Issue Advances of Locoregional Therapy for Hepatocellular Carcinoma)
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14 pages, 1612 KiB  
Article
Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma
by Hideki Iwamoto, Takashi Niizeki, Hiroaki Nagamatsu, Kazuomi Ueshima, Takako Nomura, Teiji Kuzuya, Kazuhiro Kasai, Yohei Kooka, Atsushi Hiraoka, Rie Sugimoto, Takehiro Yonezawa, Akio Ishihara, Akihiro Deguchi, Hirotaka Arai, Shigeo Shimose, Tomotake Shirono, Masahito Nakano, Shusuke Okamura, Yu Noda, Naoki Kamachi, Miwa Sakai, Hiroyuki Suzuki, Hajime Aino, Norito Matsukuma, Satoru Matsugaki, Kei Ogata, Yoichi Yano, Takato Ueno, Masahiko Kajiwara, Satoshi Itano, Kunitaka Fukuizumi, Hiroshi Kawano, Kazunori Noguchi, Masatoshi Tanaka, Taizo Yamaguchi, Ryoko Kuromatsu, Atsushi Kawaguchi, Hironori Koga, Takuji Torimura, New FP Study Group and Kurume Liver Cancer Study Group of Japanadd Show full author list remove Hide full author list
Cancers 2021, 13(4), 646; https://doi.org/10.3390/cancers13040646 - 5 Feb 2021
Cited by 24 | Viewed by 3095
Abstract
BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally [...] Read more.
BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [(without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS. Full article
(This article belongs to the Special Issue Advances of Locoregional Therapy for Hepatocellular Carcinoma)
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