Preliminary investigation of the effect on transcatheter arterial chemoembolization for osseous metastases of hepatocellular carcinoma

doi:10.3877/cma.j.issn.1647-0793.2013.01.006

Abstract

Abstract:

Objective

To preliminarily investigate the effect of transcatheter arterial chemoembolization(TACE) for osseous metastases of hepatocellular carcinoma(HCC).

Methods

Fifteen cases of HCC companied with single(12 cases) or multiple(3 cases) osseous metastases were enrolled. Imageologic examination was performed to the local osseous focuses, and the visual analog scales (VAS) method was used to evaluate the degree of local pain before and after TACE for osseous metastases. Follow-up were performed above 3 months for all patients.

Results

Fifteen cases successfully underwent TACE for local osseous metastases. The VAS score of all patients were above 7 and the local pain had relieved in varying degrees after therapy. According to VAS criterion, the follow-up visit after one month presented 3 cases with complete relief, 7 cases with distinct relief and 5 cases with mild relief. The effective rate of pain relief was 80.0% at the third month after therapy and 58.3% at the sixth month. The effective rate was 86.7% by imageology evaluation. The AFP level reduced more than 50% in 5 cases, more than 30% in 8 cases and more than 20% in 2 cases. The survival rate of the cases was 100% at the third month after TACE for osseous metastases, while 80% at the sixth month.

Conclusion

TACE is available to release pain and control of local lesions for osseous metastases of HCC, also improve the quality of life.

Key words: Hepatocellular carcinoma, Bone tumor/ metastasis, Embolization

Guo-sheng TAN, Xian-hong XIANG, Bing ZHANG, Jia-ping LI, Wen-bo GUO, Wen-quan ZHUANG, Wei CHEN, Jian-yong YANG. Preliminary investigation of the effect on transcatheter arterial chemoembolization for osseous metastases of hepatocellular carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(01): 21-25.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1647-0793.2013.01.006

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2013/V07/I01/21

Figures/Tables 3

References 17

1	Melichar B, Voboril Z, Toupkova M, et al. Hepatocellular carcinoma presenting with bone metastasis. J Exp Clin Cancer Res, 2002, 21(3): 433-436.
2	Kim SU, Kim DY, Park JY, et al. Hepatocellular carcinoma presenting with bone metastasis: clinical characteristics and prognostic factors. J Cancer Res Clin Oncol, 2008, 134(12): 1377-1384.
3	Attili VS, Babu KG, Lokanatha D, et al. Bone metastasis in hepatocellular carcinoma: need for reappraisal of treatment. J Cancer Res Ther, 2008, 4(2): 93-94.
4	Seong J, Koom WS, Park HC. Radiotherapy for painful bone metastases from hepatocellular carcinoma. Liver Int, 2005, 25(2): 261-265.
5	Nakamura N, Igaki H, Yamashita H, et al. A retrospective study of radiotherapy for spinal bone metastases from hepatocellular carcinoma. Jpn J Clin Oncol, 2007, 37(1): 38-43.
6	Young KJ, Jong EY, Chung HK, et al. A case of metastatic hepatocellular carcinoma of the rib, treated by transcatheter arterial chemoembolization. Korean J Hepatol, 2009, 15(3): 357-361.
7	Junko T, Toshiaki T, Nagaaki M, et al. Hepatocellular carcinoma of the iliac bone with unknown primary. Skeletal Radiol, 2010, 39(7): 721-724
8	Giesen HU. Cancer pain: therapy according to the pain relief ladder. MMVV Fortschr Med, 2010, 152(21): 91-95.
9	张福君，吴沛宏，卢鸣剑, 等. ¹²⁵Ⅰ粒子组织间置入治疗骨转移瘤. 中华放射学杂志, 2007, 41(1): 76-78.
10	Sande TA, Ruenes R, Lund JA, et al. Long-term follow-up of cancer patients receiving radiotherapy for bone metastases: results from a randomised multicentre trial. Radiother Oncol, 2009, 91(2): 261-266.
11	Kotteas E, Alamara C, Kiagia M, et al. Safety and efficacy of zoledronic acid rapid infusion in lung cancer patients with bone metastases: a single institution experience. Anticancer Res, 2008, 28(1B): 529-533.
12	Lutz S, Hoskin P, Chow E. Update on palliative radiotherapy endpoints for bone metastasis trials.Clin Oncol (R Coll Radiol), 2009, 21(9): 659-661.
13	Harada H, Nishimura T, Kamata M, et al. Radiotherapy for bone metastases from hepatocellular carcinoma and pancreas cancer. Gan To Kagaku Ryoho, 2006, 33(8): 1061-1064.
14	Koike Y, Takizawa K, Ogawa Y, et al. Transcatheter arterial chemoembolization (TACE) or embolization (TAE) for symptomatic bone metastases as a palliative treatment. Cardiovasc Intervent Radiol, 2011, 34(4): 793-801.
15	刘军麟. 化疗栓塞联合其它方法治疗肝细胞癌的评价[J/CD]. 中华普通外科学文献:电子版, 2007, 1(3): 181.
16	林志强，俞武生，王在国, 等. 术前接受经导管肝动脉化疗栓塞肝癌患者的生存分析[J/CD]. 中华普通外科学文献:电子版, 2008, 2(3): 209-213.
17	Imamura H, Masutani S, Ttsuta M, et al. A case report of successful transcatheter arterial embolization therapy for osseous metastasis of HCC. Gan To Kagaku Ryoho, 2000, 27(12): 1941-1946.

骨转移部位	数目(个)	百分比(%)	栓塞材料
胸椎	2	11.1	明胶海绵加PVA （700～900 μm）
腰椎	5	27.8	明胶海绵加PVA （700～900 μm）
髂骨	8	44.4	PVA（700～900 μm及500～700 μm）加明胶海绵
骶骨	2	11.1	PVA（700～900 μm及500～700 μm）加明胶海绵
四肢骨	1	5.6	PVA（700～900 μm及500～700 μm）加明胶海绵

骨转移部位	数目(个)	百分比(%)	栓塞材料
胸椎	2	11.1	明胶海绵加PVA （700～900 μm）
腰椎	5	27.8	明胶海绵加PVA （700～900 μm）
髂骨	8	44.4	PVA（700～900 μm及500～700 μm）加明胶海绵
骶骨	2	11.1	PVA（700～900 μm及500～700 μm）加明胶海绵
四肢骨	1	5.6	PVA（700～900 μm及500～700 μm）加明胶海绵

随访时间	0分	1~3分	4~6分	≥7分
治疗前	0（0.0）	0（0.0）	0（0.0）	15（100.0）
治疗后1个月	3（20.0）	7（46.7）	5（33.3）	0（0.0）
治疗后3个月	1（6.7)	5（33.3）	6（40.0）	3（20.0）
治疗后6个月^a	0（0.0)	1（8.3）	6（50.0）	5（41.7）

随访时间	0分	1~3分	4~6分	≥7分
治疗前	0（0.0）	0（0.0）	0（0.0）	15（100.0）
治疗后1个月	3（20.0）	7（46.7）	5（33.3）	0（0.0）
治疗后3个月	1（6.7)	5（33.3）	6（40.0）	3（20.0）
治疗后6个月^a	0（0.0)	1（8.3）	6（50.0）	5（41.7）

[1]	Miao Li, Lianhua Zhu, Peng Han, Bo Jiang, Xiang Fei. Evaluation of relationsip between vascular morphology and risk factors for hepatocellular carcinoma by high-frame-rate contrast-enhanced ultrasound [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 911-915.
[2]	Jianmin Ding, Zhengyi Qin, Xiang Zhang, Yan Zhou, Hongyu Zhou, Yandong Wang, Xiang Jing. Contrast-enhanced ultrasound versus gadoxetic acid-enhanced magnetic resonance imaging for LI-RADS classification of focal liver lesions ≤3 cm in patients at high risk of hepatocellular carcinoma: a prospective study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 930-938.
[3]	Jie Dong, Song Yang, Hao Yang, Xiang Chen, Wanli Zhang. Relationship between hypermethylation of ACACB gene and clinicopathological factors and survival of hepatocellular carcinoma [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 433-437.
[4]	Wei Huang, Qi Liu, Liuhua Chen, Chaxiang Teng, Zhejian Ou, Hanxiao Liu, Jiancong Chen, Kunsong Zhang. Identification of a pyroptosis-related lncRNA signature as a novel prognostic biomarker for hepatocellular carcinoma [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(05): 357-365.
[5]	Qian Yang, Cuifang Li, Wanqiu Zhang. Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 33-36.
[6]	Jianmei Li, Jingjuan Deng, Qian Yang. Safety and follow-up evaluation of the combined treatment of hepatocellular carcinoma with hepatic cirrhosis and portal hypertension [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 41-44.
[7]	Yafeng Chen, Jiangbin Li, Dong Wang, Li Zang, Jianguo Lu, Rui Dong. Application of laparoscopic splenectomy in the treatment of massive splenomegaly long-term after splenic artery embolization [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(05): 571-574.
[8]	Liangzhen Zhu, Yonggang Yu, Gao Chen, Songbai Liao. Comparison of surgery and renal artery embolization for high-grade blunt renal trauma in pediatric [J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(05): 461-465,475.
[9]	Wenhua Zhang, Cui Tao, Tiansong Hu. Clinicopathological characteristics of pedunculated hepatocellular carcinoma in different sites and its effects on postoperative intrahepatic recurrence and prognosis [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 651-655.
[10]	Jiaqi Cui, Di Wu, Haiyan Chen, Huimin Zhou, Yuanlong Gu, Guangwen Zhou, Jun Yang. Clinical diagnosis and treatment of liver abscess after TACE [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 688-693.
[11]	Hongyu Meng, Yi Lu, Yanlong Cao, Cao Dai, Jiawei Yang, Nan Lin, Jianliang Xu. Comparison of therapeutic effect between TACE combined with radiofrequency ablation and radiofrequency ablation alone for small liver cancer based on propensity score matching [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(04): 417-421.
[12]	Baoru Hu, Naijian Shang, Di Gao. DCE-MRI and DWI findings of advanced hepatocellular carcinoma and their correlation with prognosis after immunotherapy [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 399-403.
[13]	Fengyun Wu, Xin Teng, Lianjuan Liu. Diagnostic value of high-frequency ultrasonography and enhanced magnetic resonance for primary hyperdifferentiated hepatocellular carcinoma of different diameters [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 404-408.
[14]	Bin Zhou, Xinxian Liu. Effect of preoperative TACE on improving long-term survival in children with hepatoblastoma [J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(04): 314-317.
[15]	Yaqin Wu, Wei Mo, Hua Xiang, Qin Li, Yulian Li, Bifang Zhou. Research progress on bleeding at femoral artery puncture site after interventional therapy for liver cancer patients [J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(04): 352-356.

Please choose a citation manager

Content to export