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Balloon-occluded transarterial chemoembolization for hepatocellular carcinoma : History, background, and the roles
http://hdl.handle.net/2241/00161451
http://hdl.handle.net/2241/001614515915bbd5-d3eb-4f02-b4aa-46b468e6719a
名前 / ファイル | ライセンス | アクション |
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IJGI_9-1 (1.6 MB)
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Item type | Journal Article(1) | |||||
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公開日 | 2020-09-24 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Balloon-occluded transarterial chemoembolization for hepatocellular carcinoma : History, background, and the roles | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | journal article | |||||
著者 |
入江, 敏之
× 入江, 敏之× 星合, 壮大× Takahashi, Nobuyuki |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Super-selective lipiodol balloon-occluded transarterial chemoembolization (SSLB-TACE) increases lipiodol accumulation in the targeted nodule. To understand the mechanism of increased accumulation, it is necessary to understand intra-hepatic collateral system and rheology of lipiodol. Although SSLB-TACE is thought to be a promising technique, randomized prospective controlled trials to compare local control rates with conventional super-selective lipiodol (c-TACE) are still lacking. Another problem for SSLB-TACE is change of TACE candidates by development of radiofrequency ablation (RFA) technology. Patients with limited number of small nodules are good candidates for both SSLB-TACE and c-TACE, but these are also good candidates for RFA. Because higher priority is given to RFA, TACE is usually indicated for patients with 4 or more nodules, with large nodule(s), and/or with proximal Glisson attaching nodule(s). However, these cases are known as TACE-refractory, and the chance to perform SSLBTACE or c-TACE would be markedly decreased in institutions where RFA is aggressively performed. In the past, paradigm shift from non-selective TACE to super-selective TACE occurred, and the goal of SSLB-TACE and c-TACE is prolonged complete remission of the treated nodules while sacrificing small volume of liver parenchyma. But another TACE technique, aiming treatment of wide region (hemi-lobe or more) and effective tumor volume reduction while minimizing liver parenchymal damage, is mandatory in RFA era. For this purpose, we developed a new balloon-occluded TACE without using lipiodol; alternate infusion of cisplatin solution and sparse gelatin slurry was repeated under balloon-occlusion (RAIB-TACE) until stasis of gelatin slurry in proximal hepatic arteries was seen. However, not only RFA but also recent development of molecular targeted drugs strongly influences on the indication and the aim of TACE. The goal and technique of TACE should be properly selected in each era, in each institution, and for each patient. | |||||
書誌情報 |
en : International Journal of Gastrointestinal Intervention 巻 9, 号 1, p. 13-18, 発行日 2020-01 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 2636-0004 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.18528/ijgii190025 | |||||
権利 | ||||||
権利情報 | © 2020, Society of Gastrointestinal Intervention. | |||||
権利 | ||||||
権利情報 | This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. | |||||
著者版フラグ | ||||||
値 | publisher | |||||
出版者 | ||||||
出版者 | Society of Gastrointestinal Intervention |