Hepatic Cell Carcinoma Clinical Trial
Official title:
Effectiveness of Drug Eluting & Conventional Trans-arterial Chemo-embolization in Treatment of Primary Hepatic Cell Carcinoma
the aim of this work to compare effectiveness of drug-eluting bead trans-arterial chemo-embolization and conventional trans-arterial chemo-embolization of hepatic cell carcinoma in the aspect of (Tumor response via m-RECIST criteria), (liver injury via Liver function tests and tumor markers) and (survival outcome) of patients treated in Assiut university .
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the third
most common cause of cancer-related death .. With improved surveillance of patients with
chronic liver disease and advances in imaging, more patients are diagnosed with early-stage
HCC . For the treatment of early stage HCC, curative therapies including liver
transplantation, hepatic resection, and radio frequency ablation (RFA) are recommended. Liver
transplantation is the treatment option especially for patients with decompensated cirrhosis,
but potential recipients outnumber donors. Hepatic resection is widely used as the main
choice of treatment for resectable HCC. However, the risk of postoperative hepatic
dysfunction often precludes surgery.
For unresectable patient, trans-arterial chemo-embolization (TACE) was the treatment of
choice .
At 2014, Yang et al. compared the treatment effects of hepatic resection, RFA, and
conventional TACE on long-term survival. It was found that the range of patients treated by
TACE in clinical practice reported survivals widely range from 8-26% at 5-years. which was
similar to that with hepatic resection and RFA in patients with single-nodule HCC of 3 cm or
smaller without vascular invasion when the underlying liver status was balanced among the
patients receiving each treatment. In addition, most of the patients initially treated with
c-TACE achieved a complete response, which was one of the independent prognostic factors of
survival, although some should receive repeated treatments. However, when c-TACE is used as
an initial treatment, special care should be taken to obtain a complete response, and
surveillance for tumor recurrence should be undertaken. These results are consistent with
those of cohort studies demonstrating that TACE provided overall survival similar to hepatic
resection in early-stage HCC .
Conventional (Lipiodol) TACE Base on technique with emulsified combination of chemotherapy
such as Doxorubicin and Lipiodol administrate via arterial feeder.
Less in systemic chemotherapy and increase overall survival rate were the most concern in
treatment but many studies reported side effects from conventional (Lipiodol) TACE
significantly among an improvement of overall survival rate .
Conventional TACE may cause side effects because it can damage healthy cells as it kills
cancer cells. Side effects can develop any time during, immediately after or a few days or
weeks after chemotherapy . in addition to the patient needed frequent ablation after a short
time .
The most commonly Side Effect of TACE is (Post embolization syndrome) which is a group of
symptoms . include : fever, Right upper quadrant pain, nausea, vomiting and fatigue .
Other side effects may occur include bruising or bleeding at the catheter site, hair loss,
abnormal liver functions, lung infections, gall bladder inflammation and tumor lysis syndrome
.
Drug-eluting bead TACE is the new method of delivering chemotherapy during TACE which uses
special beads that already have the chemotherapy drug in them . after these are injected into
the arteries of the liver , they slowly sustained releasing the drug to treat the tumor .
The studies showed that TACE with (Hepasphere) less systemic side effect in patient than TACE
with (Lipiodol) but no definite statistical difference in treatment and survival outcome.
This study compares effectiveness of those methods in treatment of Hepatocellular carcinoma
in Assiut university
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