Pharmaceutical and Methodological Aspects of Microparticles
Neville Willmott, John Daly in Microspheres and Regional Cancer Therapy, 2020
The greatest advantage would be obtained by a drug delivery system that not only enhanced delivery of the drug to the target organ but also prevented loss of the drug in the efferent venous drainage from that organ. Microspheres and microcapsules, collectively referred to as microparticles, have been described for delivery of active agents to target organs.1 Due to their size they are trapped in the micro-vasculature of tissues, when administered via the regional artery, where they release their drug payload. The procedure is termed chemoembolization. Microspheres are monolithic and may contain dispersed drug molecules either in solution or solid form, whereas microcapsules consist of drug concentrated in a central core inside a polymer-rich wall or shell. Figure 1 illustrates the basic structures of these two microparticles, although variations have been described.2
Cytoreduction of neuroendocrine tumors
Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner in Endocrine Surgery, 2017
The results of ischemic treatments of liver metastases are dependent on a number of variables. In a retrospective study, patients with carcinoid tumors had a higher response rate and longer progression-free survival than patients with pancreatic NETs [47] after bland embolization or chemoembolization. An intact primary tumor, extensive liver involvement, and extrahepatic disease were associated with reduced survival in patients with pancreatic NETs. In a long-term follow-up study, 80% of patients with hormonally active tumors had relief of symptoms after one cycle of treatment, and it was concluded that the presence of extrahepatic disease or unresected primary should not limit the use of embolization [48]. The relative merits of chemoembolization versus selective embolization await further studies [49].
Hepatocellular carcinoma
Pat Price, Karol Sikora in Treatment of Cancer, 2014
Two small randomized trials have shown survival benefit from chemoembolization48,49 (Figure 9.5), and a meta-analysis of seven trials, incorporating 545 patients, confirmed improved survival compared with supportive care or systemic therapy.50 The general applicability of this meta-analysis is, however, limited in view of its relatively small size; the heterogeneity of the patient populations and the techniques used; and differences in the choice of chemotherapeutic agent, embolic agent and the use of lipiodol. The key to successful chemoembolization is patient selection, with the ideal candidate having well-preserved liver function and a small tumour volume.51
Intratumoral Pi deprivation benefits chemoembolization therapy via increased accumulation of intracellular doxorubicin
Published in Drug Delivery, 2022
Yang-Feng Lv, Zhi-Qiang Deng, Qiu-Chen Bi, Jian-Jun Tang, Hong Chen, Chuan-Sheng Xie, Qing-Rong Liang, Yu-Hua Xu, Rong-Guang Luo, Qun Tang
The conventional method used to downregulate the expression of ABC transporters and reverse drug resistance in HCC is to introduce novel drugs, including cantharidin, glycyrrhizin and lamivudine, resveratrol and levistolide (Wakamatsu et al., 2007; Zheng et al., 2008; Kim et al., 2014; Ding et al., 2019). Our investigation was undertaken to resolve this unsettled issue by utilizing the local-regional technique to change the tumor chemo-environment. We try to address drug resistance by a subtraction strategy, instead of through addition as is normally done. Since chemoembolization therapy temporarily cuts off the blood supply from the artery, the tumor is isolated for a longer or shorter time, depending on the different embolic agents. This isolation starves cancer cells from nutrients and oxygen, thereby changing the tumor chemical microenvironment for some time and inducing features such as severe hypoxia, which is considered a critical promoter of tumor recurrence and drug resistance (Petrillo et al., 2018; Bao & Wong, 2021). The advantage is that the embolotherapy technique can also be utilized to create a new chemical environment, such as through inducing Pi starvation. In this particular chemo-microenvironment of low Pi stress, the relationship between Pi starvation, the amount of DOX retention, and the tumor necrosis ratio was evidenced.
Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study
Published in Journal of Investigative Surgery, 2022
Guifang Zeng, Baojia Zou, Yongliang Li, En Lin, Xialei Liu, Peiping Li, Jiafan Chen, Baimeng Zhang, Yingbin Jia, Chaonong Cai, Jian Li
All enrolled HCC patients underwent radical hepatectomy as described above [16]. All patients but those with contraindications were recommended to receive PA-TACE at 1-2 months after surgery when the liver function had recovered. Whether patients accepted the doctor’s recommendation or not mainly depended on their financial conditions, compliance with the doctors, or other factors. Before PA-TACE, they were routinely examined for liver function, serum AFP, thoracic and abdominal CT, and/or liver MRI to determine whether the tumor recurred or metastasized. PA-TACE was carried out using the Seldinger technique for the residual liver: a hepatic arterial catheter was inserted selectively into the tumor-feeding artery as technically as possible through the femoral artery. Hepatic digital subtraction angiography (DSA) was used to detect whether there were obvious tumor stains within the residual liver. Chemotherapeutic agents, fluorouracil 10 mg, carboplatin 40 mg, and lipiodol 10 ml were injected through the catheter for chemoembolization.
Long-term efficacy of microwave ablation in the treatment of subcapsular hepatocellular carcinomas of ≤3 cm in diameter: a multicenter, propensity score-matched study
Published in International Journal of Hyperthermia, 2022
Jundong Yao, Binbin Liu, Xiaohui Wang, Jie Yu, Zhigang Cheng, Zhiyu Han, Fangyi Liu, Rongqin Zheng, Wen Cheng, Qiang Wei, Songyuan Yu, Kai Li, Peng Chen, Yanchun Luo, Xiaoling Yu, Ping Liang
We used data from a multicenter database, which included the Chinese PLA General Hospital, Third Affiliated Hospital of Sun Yat-Sen University, Harbin Medical University Cancer Hospital, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, and Wuhan University of Science and Technology Tianyou Hospital. From January 2012 to December 2018, a total of 430 patients (532 lesions) with HCCs who underwent MWA were screened out. The diagnosis of HCC was based on needle biopsy (n = 293) or typical imaging features (n = 137). The inclusion criteria were as follows: (a) number of nodules of ≤3 and diameter of ≤3 cm, (b) Child-Pugh grade of A or B, (c) initial onset of HCC, and (d) perioperative laboratory test results that met the surgical standards. The exclusion criteria were as follows: (a) vascular and/or bile duct invasion on imaging, (b) preoperative chemotherapy and/or transcatheter arterial chemoembolization (TACE), (c) history of liver transplantation, (d) extrahepatic metastasis, (e) history of other organ malignancies, (f) tumor adjacent to large blood vessels and/or hila, (g) presence of both subcapsular and non-subcapsular tumors, and (h) incomplete data. A subcapsular location was defined as location of a tumor within 5 mm of the liver capsule. According to the tumor location, the patients were divided into subcapsular (n = 143) and non-subcapsular (n = 287) groups (Figure 1).
Related Knowledge Centers
- Cytotoxicity
- Embolism
- Neoplasm
- Artery
- Catheter
- Minimally Invasive Procedure
- Interventional Radiology
- Radiation Therapy
- Selective Internal Radiation Therapy
- Hepatic Artery Proper