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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 | Implications for human health of the extensive bisphenol A literature showing adverse effects at low doses: A response to attempts to mislead the public 显示文摘 | Vom S F Nagel S C Timms B G | 2005 | Toxicology2005，212，23： | 1 |
| 3 | Spin Amplification,Reading,and Writing in Transport Through Anisotropic Magnetic Molecules显示文摘 | Timm C Elste F | 2006 | Phys Rev B2006，73，23： | 1 |
| 4 | Difference gel electrophoresis显示文摘 | Timms J F Cramer R | 2008 | Pro- teomics2008，8，2324： | 1 |
| 5 | Treatment of urinary incontinence by implantable prosthetic sphincter 显示文摘 | Scott F B Bradley W E Timm G W | 1973 | Urol1973，1，： | 1 |
| 6 | Prostateenlargement in mice due to fetal exposure to low doses of estradiol ordiethylstilbestrol and opposite effects at high doses显示文摘 | vom SAAL F S TIMMS B G MONTANO M M | 1997 | Proceedings ofthe National Academy of Sciences1997，94，5： | 1 |
| 7 | Spin Amplification, Reading,and Writing in Transport Through Anisotropic Magnetic Molecules显示文摘 | TIMM C ELSTE F | 2006 | Phys Rev B2006，73，23： | 1 |
| 8 | An examination of cost economics in the United States life insurance industry显示文摘 | Grace M F S G Timme | 1992 | Journal of Risk and Insurance1992，59，： | 1 |
| 9 | Transport Through Anisotropic Magnetic Molecules with Partially Ferromagnetic Leads:Spin Charge Conversion and Negative Differential Conductance显示文摘 | TIMM C ELSTE F | 2006 | Phys Rev B2006，73，23： | 1 |
| 10 | An examination of cost economics in the United States life insurance industry显示文摘 | Grace M F S G Timme | 1992 | Journal of Risk and Insurance1992，59，： | 1 |
| 11 | Generation and transit pathway,of H^+ is critical for inhibition of palmar sweating by iontophoresis in water显示文摘 | Sato K Timm DE Sato F | 1993 | J Appl Physiol1993，75，5： | 1 |
| 12 | Assays for laboratory confirmation of novel human coronavirus (hCoV-EMC) infections显示文摘 | Corman V M Mtiller M A Costabel U Timm J Bin- ger T Meyer B Kreher P Lattwein E Eschbach- Bludau M Nitsche A Bleicker T Landt O Schweiger B Drexler J F Osterhaus A D Haagmans B L Dittmer U Bonin F Wolff T Drosten C | 2012 | Euro Surveill2012，17，20： | 1 |
| 13 | Nonlinear model predictive path-following control 显示文摘 | TIMM F ROLF F | 2009 | Lecture Notes in Control and Information Sciences2009，384，： | 1 |
| 14 | The Effect of Supplementing Diet with Saccharomyecs Cerevisiae Var Boulardii on Male Poult Performanceand Llealmorphology显示文摘 | Bradly G L Savage T F Timm K I | 1994 | Poultry Sci1994，，73： | 1 |
| 15 | Treatment of urinary inconti-nence by an implantable prosthetic urinary sphincter显示文摘 | Scott F B Bradley W E Timm G W | 2002 | J Urol2002，167，11： | 1 |
| 16 | Relation of individual forces on apples and bruising during orchard transport of bulk bins显示文摘 | Bollen A F Timm E J Dela Rue B T | 2001 | Appl Eng Agric2001，17，2： | 1 |
| 17 | An examination of cost economies inthe United States life insurance industry显示文摘 | Grace M F Timme S G | 1992 | Journal of Risk andInsurance1992，59，： | 1 |
| 18 | PCR detection and differentiation of Chlamydia pneumoniae, Chlamydia psittaci and Chlamydia trachomatis 显示文摘 | Rasmussen S J Douglas F P Timms P | 1992 | Mol Cell Probes1992，6，： | 1 |
| 19 | The effect of heat on wheat gluten and the involvement of sulphydryl-disulphide interchange reactions显示文摘 | Schofield J D Bottomley R C Timms M F | | 0，，04： | 1 |
| 20 | Hypoxia-inducible factor expression in human RPE cells显示文摘 | Forooghian F Razavi R Timms L | 2007 | Br J Ophthalmol2007，91，10： | 1 |
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