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김명환 ( Myoung Hwan Kim ), 안상훈 ( Sang Hoon Ahn ), 백용한 ( Yong Han Paik ), 이관식 ( Kwan Sik Lee ), 전재윤 ( Chae Yoon Chon ), 문영명 ( Young Myoung Moon ), 성진실 ( Jin Sil Seong ), 한광협 ( Kwang Hyub Han ) 대한간암연구회 2005 대한간암학회지 Vol.5 No.-
Hepatic arterial infusion chemotherapy (HAIC) is performed in patients with advanced hepatocellular carcinoma (HCC) in which locoregional therapeutic methods such as transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI) or radiofrequency ablation (RFA) could not be the best choice. Sorafenib, the only approved systemic chemotherapeutic agent for HCC, improves survival rate, but is associated with a low tumor response rate. Thus combining these therapeutic modalities to treat HCC in advanced stage may help downstaging and leading to better treatment results without taking risk for hepatic failure. Here we report a case treated to a complete remission by combining HAIC, PEI and sorafenib.
A functional and biochemical features of TIS21(/BTG2/PC3) was explored in hepatocarcinogenesis. Growth of hepatocellular carcinoma (HCC), developed by a single injection of diethylnitrosamine (DEN) was significantly higher in the TIS21 knockout mice at 9 months. Expression of BTG2/TIS21 was significantly lower in both human and mouse hepatocellular carcinoma than in the surrounding normal tissues. Over-expression of TIS21 inhibited cell proliferation and tumorigenic potential of Huh7 hepatoma cells. At the molecular mechanistic level, TIS21 inhibited FoxM1 phosphorylation, by reducing cyclin B1-cdk1 activity. Furthermore, TIS21 inhibited FoxM1 transcriptional activity. In conclusion, TIS21 negatively regulated hepatocarcinogenesis in part by disruption of the FoxM1-cyclin B1 regulatory loop, thereby inhibiting proliferation of transformed cells developed in mouse and human livers.
Transarterial chemo-embolization using adriamycin or cisplatin, lipiodol and gelfoam (TACE-Adr or -CDDP) has been recommended for the treatment of hepatocellular carcinoma (HCC), which are not indicated for the curative therapy, such as liver transplantation, operation, and radiofrequency ablation therapy (RFA). However, TACE-Adr/-CDDP protocol is effective only for single or few nodular HCCs with largest diameter less than 6 cm and without major vascular involvement or distant metastasis (AJCC/UICC 6th.edition-TNM-II). To treat more complicated far advanced HCCs, various multiplicinary approaches have been tried, but most studies are too preliminary and immature to be used as standard treatment protocols. In such situation, a combination protocol, called TACE-EC/F, in which TAC-Epirubicin and Cisplatin is followed by systemic intra-venous infusion of 5-fluorouracil (5-FU), has been a good option. To improve its therapeutic efficacy, I replaced its systemic 5-FU (for 5 days continuous) infusion part to the (one time) percutaneous intratumoral injection chemotherapy (PIC) with a mixture of high dose 5-FU and recombinant interferon-gamma (IFN-gamma), named PIC-IF. This protocol was developed based on both the results of several experimental data and many clinical experience of percutaneous ethanol injection therapy (PEIT). This TACE-EC/PIC-IF protocol showed a possibility of new multimodality approach for the treatment of advanced HCC.
( Eek Joong Park ), ( Jun Hee Lee ), ( Guann Yi Yu ), ( Guo Bin He ), ( Syed Raza Ali ), ( Ryan G. Holzer ), ( Christoph H. Osterreicher ), ( Takahashi Hiroyuki ), ( Michael Karin ) 대한간암연구회 2010 대한간암학회지 Vol.10 No.-