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Titolo:
Randomized control trials on chemoembolization for hepatocellular carcinoma - Is there room for new studies?
Autore:
Trevisani, F; De Notariis, S; Rossi, C; Bernardi, M;
Indirizzi:
Univ Bologna, Dipartimento Med Interna, I-40138 Bologna, Italy Univ Bologna Bologna Italy I-40138 o Med Interna, I-40138 Bologna, Italy Univ Bologna, Dipartimento Sci Radiol & Istocitopatol, I-40138 Bologna, Italy Univ Bologna Bologna Italy I-40138 Istocitopatol, I-40138 Bologna, Italy
Titolo Testata:
JOURNAL OF CLINICAL GASTROENTEROLOGY
fascicolo: 5, volume: 32, anno: 2001,
pagine: 383 - 389
SICI:
0192-0790(200105/06)32:5<383:RCTOCF>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; PERCUTANEOUS ETHANOL INJECTION; TRANSARTERIAL CHEMOEMBOLIZATION; LIPIODOL CHEMOEMBOLIZATION; OILY CHEMOEMBOLIZATION; SYMPTOMATIC TREATMENT; NATURAL-HISTORY; EMBOLIZATION; RESECTION; SURVIVAL;
Keywords:
randomized control trials; chemoembolization; hepatocellular carcinoma;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Trevisani, F Univ Bologna, Dipartimento Med Interna, Via Massarenti 9, I-40138 Bologna,Italy Univ Bologna Via Massarenti 9 Bologna Italy I-40138 na,Italy
Citazione:
F. Trevisani et al., "Randomized control trials on chemoembolization for hepatocellular carcinoma - Is there room for new studies?", J CLIN GAST, 32(5), 2001, pp. 383-389

Abstract

Hepatocellular carcinoma (HCC) generally occurs in patients with cirrhosis. Curative options, such as liver transplantation, hepatic resection, and percutaneous alcohol injection, are applicable to a minority of cases. Because systemic chemotherapy and radiation therapy provide dismal results, transarterial chemoembolization (TACE) remains the sole approach to antagonizing the cancer growth in most patients. Although most tumors show an extensive necrosis after TACE, the beneficial effect on survival has not been properly substantiated, so that its application still remains a matter of debate. This review analyzes the results of randomized clinical trials on TACE. In most studies, TACE did not increase the survival of patients as compared with the palliative treatment. However, several methodologic and technical pitfalls may have adversely affected the results of these trials, such as inadequate patient selection and statistical power of the study design, a nonoptimal procedure, and treatment repetition not tailored to the cancer response and patient tolerance. Nonetheless, the literature will hardly be enriched by new trials including untreated patients because, wrong or right, TACE is currently considered the standard treatment of unresectable HCC. It seems more realistic to expect randomized studies comparing different techniques and time schedules of treatment, as well as TACE alone versus combined procedures.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 15:05:28