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  • 2005-2009  (2)
  • 1
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Radiographic measurements do not always reflect the biological response of hepatocellular carcinoma to drug therapy.Aims:  To evaluate the clinical implications of tumour marker (α-fetoprotein) response in advanced hepatocellular carcinoma patients with thalidomide treatment.Patients and methods:  Forty-two advanced hepatocellular carcinoma patients with baseline α-fetoprotein levels above 200 ng/mL and thalidomide therapy were included. Serum α-fetoprotein levels were measured every 4 weeks. α-fetoprotein response was defined as a 50% or greater reduction of α-fetoprotein levels for 4 or more weeks during treatment. Radiographic response was assessed by World Health Organization criteria; survivals were estimated by Kaplan–Meier method and prognostic factors were assessed by Cox's proportional hazard model.Results:  With intention-to-treat analysis, radiographic response and α-fetoprotein response were obtained in 7% (three of 42, 95% confidence interval: 0–15) and 24% (10 of 42, 95% CI: 10–38) of patients, respectively. All radiographic response was observed in α-fetoprotein responders. Multivariate analyses showed α-fetoprotein response was independent prognostic factor for both progression-free survival (relative risk = 0.394, 95% CI: 0.189–0.820, P = 0.013) and overall survival (relative risk = 0.241, 95% CI: 0.096–0.606, P =0.003), whereas radiographic response was not.Conclusion:  α-fetoprotein response can more accurately reflect the biological response of advanced hepatocellular carcinoma to thalidomide therapy than radiographic response.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Transcatheter arterial embolization is a major palliative treatment for unresectable hepatocellular carcinoma, but the survival benefit of transcatheter arterial embolization is controversial.Aim:  To evaluate the role of transcatheter arterial embolization in different stage of unresectable hepatocellular carcinoma and to select patients who can get the best benefit from the treatment.Methods:  From 1991 to 1995, 476 patients who had unresectable hepatocellular carcinoma from four medical centres in Taiwan were enrolled. Among them, 425 underwent transcatheter arterial embolization, and 51 received supportive treatment alone. The survivals between the two groups were compared.Results:  Among the 476 patients, transcatheter arterial embolization can significantly prolong survival. The 1-, 2-, and 5-year survival rates for patients who underwent transcatheter arterial embolization were 60.2%, 39.3%, and 11.5%; and the rates for patients who underwent supportive treatment were 37.3%, 17.6%, and 2%, respectively (P = 0.0002). The survival benefit of transcatheter arterial embolization was observed in patients between Cancer and the Liver Italian Program 0 and Cancer and the Liver Italian Program 4. In multivariate analysis, transcatheter arterial embolization, tumour size 〈5 cm and earlier Cancer and the Liver Italian Program stage were independent factors associated with a better survival.Conclusions:  For patients who fulfilled the criteria of transcatheter arterial embolization, embolization can serve as a primary treatment for patients with unresectable hepatocellular carcinoma. The survival benefit of transcatheter arterial embolization is regardless of tumour stages.
    Type of Medium: Electronic Resource
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