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| 1 | Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival显示文摘BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (<400 ng/ml) (Odds ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All complications were managed conservatively. The mortality within 6 weeks after TACE was 2.1% (one patient). CONCLUSIONS: DSM and Lipiodol were combined successfully in the palliative TACE treatment of advanced HCC resulting in high rates of tumor response and survival at limited toxicity. Favourable tumor response was associated with tumor extent and vascularization. TACE using DSM and Lipiodol can be considered a suitable palliative measure in patients who might not tolerate long acting embolizing agents. | Timm D Kirchhoff Joerg S Bleck Arne Dettmer Ajay Chavan Herbert Rosenthal Sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten Stefan Kubicka Michael P Manns Michael Galanski | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，3： | 15 |
| 2 | Combination of repeated single-session percutaneous ethanol injection and transarterial chemoembolisation compared to repeated single-session percutaneous ethanol injection in patients with non-resectable hepatocellular carcinoma显示文摘瞄准:为病人评估经皮的乙醇注射(PEI ) 的治疗效果与先进, non-resectable HCC 与 transarterial chemoembolisation 的联合相比(不作声) 并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。方法:在学习时期期间接受了 PEI 治疗的所有病人根据物理地位和肿瘤程度被包括并且成层到下列治疗形式之一:联合不作声并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。包括Okuda分类,门静脉血栓的存在,腹水的存在,肿瘤的数字,最大的肿瘤直径,和假胆硷酯酶( CHE )的临床的参数的预示的价值,以及孩子呸上演, alpha-fetoprotein (法新社),发烧,复杂并发症的发生在这些组之间被估计并且比较。幸存用 Kaplan-Meier 被决定,多,变量回归分析。结果:所有病人的 1 年、 3 年的幸存是 73% 和 47% 。在亚群分析,联合不作声, PEI (1 ) 与更长的幸存被联系(1- , 3- , 5 年的幸存:90% , 52% ,和 43%) 与 PEI 治疗相比独自一个(2 )(1- , 3- , 5 年的幸存:65% , 50% ,和 37%) 。(3 ) 在起始的层化以后的第二等的 PEI 产出可比较的结果不作声(1- , 3- , 5 年的幸存:91% , 40% ,和 30%) 当在到最好的支持的照顾(4 ) 的层化以后的 PEI 与减少的幸存被联系时(1- , 3- , 5 年的幸存:50% , 23% , 12%) 。除了选择治疗形式,为更好的幸存的预言者是肿瘤数字(n <
5 ) ,肿瘤尺寸(<
5 厘米) ,在 PEI 前的没有腹水,和在 PEI 以后的稳定的假胆硷酯酶(P <
0.05 ) 。在在 PEI 以后的 2 wk 以内的死亡是 2.8%(n = 3 ) 。有 24 (8.9%) 主修在包括部分肝梗塞,焦点的肝坏死,和肝脓肿的 PEI 以后的复杂并发症。所有复杂并发症能非通过手术被管理。结论:重复单个会议的 PEI 在有以可接受、可管理的复杂并发症率的先进 HCC 的病人是有效的。病人们成层到联合不作声, PEI 能比那些独自成层到重复 PEI 期望更长的幸存。而且,有在好临床的地位的大或多重的肿瘤的病人可以也从联合获利不作声并且为第二等的 PEI 的再考虑。 | Arne Dettmer Timm D Kirchhoff Michael Gebel Lars Zender Nisar P Malek Bernhard Panning Ajay Chavan Herbert Rosenthal Stefan Kubicka Susanne Krusche Sonja Merkesdal Michael Galanski Michael P Manns Joerg S Bleck | 2006 | World Journal of Gastroenterology2006，12，23： | 14 |
| 3 | Conduction disturbances and increased atrial vulnerability in connexin40-deficient mice analyzad by transesophageal stimulation显示文摘 | Hagendorff A Schumacher B Kirchhoff S | 1999 | Circulation1999，99，： | 2 |
| 4 | Differential sensitivity of human papillomavirus type 16 (+)and type 18 (+) cervical carcinoma cells to CD95 mediated apoptosis 显示文摘 | Aguilar Lemarroy A Kirchhoff S Whitaker N | 2001 | Int J Cancer2001，93，6： | 1 |
| 5 | Up-regulation of c-FLIPshort and Reduction of Activation-induced Cell Death in CD28-costimulated Human T Cells显示文摘 | KIRCHHOFF S MULLER WW LI-WEBER M | 2000 | Eur J Immunol(S0014-2980)2000，30，10： | 1 |
| 6 | Assessment of anovel screening score for nutritional risk in predictingcomplications in gastro-intestinal surgery显示文摘 | Schiesser M Muller S Kirchhoff P | 2008 | Clin Nutr2008，27，： | 1 |
| 7 | Differentiating market strategies for disruptive technologies显示文摘 | Walsh S T Kirchhoff B A Newbert S | 2002 | IEEE Transactions on Engineering Management2002，49，11： | 1 |
| 8 | Differential sensitivity of human papillomavirus type 16(+) and type 18(+) cervical Carcinoma cells to CD95-mediated apoptosis显示文摘 | Aguilar Lemarroy A Kirchhoff S Whitaker N | 2001 | Inj Cancer2001，93，6： | 1 |
| 9 | Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery显示文摘 | Schiesser M Muller S Kirchhoff P | 2008 | Clin Nutr2008，27，4： | 1 |
| 10 | Conduction disturbances and increased atrial vulnerability in Connexir40-deficient mice analyzed by transesophageal stimulation显示文摘 | Hagendorff A Schumacher B Kirchhoff S | 1999 | Circulation1999，99，： | 1 |
| 11 | Cytosolic heat shock protein 60, apoptosis, and myocardial injury 显示文摘 | Kirchhoff SR Gupta S Knowlton AA | 2002 | Circulation2002，105，24： | 1 |
| 12 | Cytosolic HSP60, apoptosis, and myocardial injury显示文摘 | Kirchhoff SR Gupta S Knowlton AA | 2002 | Circulation2002，105，： | 1 |
| 13 | Assess- ment of a novel screening score for nutritional risk in predic- ting complications in gastro- intestinal surgery 显示文摘 | SCHIESSER M Mt~LLER S KIRCHHOFF P | 2008 | Clinical Nutrition2008，27，4： | 1 |
| 14 | Conduction disturbances and increased atrial vulnerability in connexin 40-deficient mice analyzed by transesophageal stimulation显示文摘 | Schumacher B Kirchhoff S | 1999 | Circulation1999，99，： | 1 |
| 15 | Analysis of N-ter- minal pro-B-type natriuretic peptide and cardiac index in multipie injured patients 显示文摘 | Kirchhoff C Leidel B Kirchhoff S | 2008 | Critical Care2008，12，： | 1 |
| 16 | Effects of cell concentration and growth period on articular and ear chondrocyte transplants for tissue engineering显示文摘 | Panossian A Ashiku S Kirchhoff CH | 2001 | Plast Reconstr Surg2001，108，2： | 1 |
| 17 | A multivariate analysis of po- tential risk factors for intra-and postoperative complications in 1316 elec- tive laparoscopic colorectal procedures 显示文摘 | Kirchhoff P Dincler S Buchmann P | 2008 | Ann Surg2008，248，2： | 1 |
| 18 | Analysis of N-terminal pro-B-type natriuretic peptideand cardiac index in multiple injured patients: a prospective cohort study 显示文摘 | Kirchhoff C Leidel BA Kirchhoff S | 2008 | Crit Care2008，12，5： | 1 |
| 19 | Reduced cardiac conduction velocity and predisposition to arrhythmias in connexin40-deficient mice显示文摘 | NELLES E HAGENDORFF A | 1998 | Curr Biol1998，8，： | 1 |
| 20 | MEMS fluxgate mag netometer for parallel robot application 显示文摘 | Kirchhoff M R Btittgenbach S | 2010 | Microsys- tem Technologies2010，16，5： | 1 |
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