Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy
Given the growing interest in using proton beam therapy (PBT) for hepatocellular carcinoma (HCC), it is possible that transarterial chemoembolization (TACE) could be used for selected patients who have previously undergone PBT. However, these cases can be technically challenging to treat and require...
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creator | Takei, Yohei Iizumi, Takashi Sakurai, Hideyuki Minami, Manabu Sakai, Masafumi Hasegawa, Naoyuki Fukuda, Kuniaki Hiyama, Takashi Okumura, Toshiyuki Sekino, Yuta Mori, Kensaku Takahashi, Hiroaki Kikuchi, Shunsuke |
description | Given the growing interest in using proton beam therapy (PBT) for hepatocellular carcinoma (HCC), it is possible that transarterial chemoembolization (TACE) could be used for selected patients who have previously undergone PBT. However, these cases can be technically challenging to treat and require appropriate preparation. Thus, we aimed to identify angiographic findings in this setting. We retrospectively identified 31 patients (28 men and 3 women, mean age: 69 years, range: 43–84 years) who underwent hepatic angiography plus TACE or transarterial infusion chemotherapy (TAI) for HCC that recurred after PBT (July 2007 to June 2018). We discovered four angiographic findings, which we speculate were related to the previous PBT. 18 patients experienced recurrence in the irradiated field, and 13 patients experienced recurrence outside the irradiated field. 29 patients underwent TACE and only 2 patients underwent TAI. The mean number of previous PBT treatments was 1.3 ± 0.6 (range: 1–4). The median interval from the earliest PBT treatment to hepatic angiography was 559 days (range: 34–5,383 days), and the median interval from the latest PBT treatment to hepatic angiography was 464 days (range: 34–5,383 days). Abnormal staining of the irradiated liver parenchyma was observed in 22 patients, which obscured the angiographic tumor staining in 4 patients. Development of a tortuous tumor feeder vessel was observed in 13 patients. Development of an extrahepatic collateral pathway was observed in 7 patients. Development of an arterioportal or arteriovenous shunt was observed in 4 patients. Based on these findings, we conclude that PBT was associated with various angiographic findings during subsequent transarterial chemotherapy for recurrent HCC, and familiarity with these findings will be important in developing appropriate treatment plans. |
doi_str_mv | 10.1155/2019/3580379 |
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However, these cases can be technically challenging to treat and require appropriate preparation. Thus, we aimed to identify angiographic findings in this setting. We retrospectively identified 31 patients (28 men and 3 women, mean age: 69 years, range: 43–84 years) who underwent hepatic angiography plus TACE or transarterial infusion chemotherapy (TAI) for HCC that recurred after PBT (July 2007 to June 2018). We discovered four angiographic findings, which we speculate were related to the previous PBT. 18 patients experienced recurrence in the irradiated field, and 13 patients experienced recurrence outside the irradiated field. 29 patients underwent TACE and only 2 patients underwent TAI. The mean number of previous PBT treatments was 1.3 ± 0.6 (range: 1–4). The median interval from the earliest PBT treatment to hepatic angiography was 559 days (range: 34–5,383 days), and the median interval from the latest PBT treatment to hepatic angiography was 464 days (range: 34–5,383 days). Abnormal staining of the irradiated liver parenchyma was observed in 22 patients, which obscured the angiographic tumor staining in 4 patients. Development of a tortuous tumor feeder vessel was observed in 13 patients. Development of an extrahepatic collateral pathway was observed in 7 patients. Development of an arterioportal or arteriovenous shunt was observed in 4 patients. Based on these findings, we conclude that PBT was associated with various angiographic findings during subsequent transarterial chemotherapy for recurrent HCC, and familiarity with these findings will be important in developing appropriate treatment plans.</description><identifier>ISSN: 1687-8450</identifier><identifier>EISSN: 1687-8450</identifier><identifier>EISSN: 1687-8469</identifier><identifier>DOI: 10.1155/2019/3580379</identifier><identifier>PMID: 31354819</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Ablation ; Angiography ; Cancer ; Care and treatment ; Chemoembolization ; Chemotherapy ; Development and progression ; Hepatoma ; Liver ; Liver cancer ; Medical imaging ; Medical research ; Medicine, Experimental ; Patients ; Tumors ; Veins & arteries</subject><ispartof>Journal of oncology, 2019, Vol.2019 (2019), p.1-7</ispartof><rights>Copyright © 2019 Hiroaki Takahashi et al.</rights><rights>COPYRIGHT 2019 John Wiley & Sons, Inc.</rights><rights>Copyright © 2019 Hiroaki Takahashi et al. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2019 Hiroaki Takahashi et al. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c609t-b09f57c322b3e4ba836bade2bf43da12e4940f706508babc9b5542e779427c683</citedby><cites>FETCH-LOGICAL-c609t-b09f57c322b3e4ba836bade2bf43da12e4940f706508babc9b5542e779427c683</cites><orcidid>0000-0002-8731-0081</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637669/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637669/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31354819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bilhim, Tiago</contributor><contributor>Tiago Bilhim</contributor><creatorcontrib>Takei, Yohei</creatorcontrib><creatorcontrib>Iizumi, Takashi</creatorcontrib><creatorcontrib>Sakurai, Hideyuki</creatorcontrib><creatorcontrib>Minami, Manabu</creatorcontrib><creatorcontrib>Sakai, Masafumi</creatorcontrib><creatorcontrib>Hasegawa, Naoyuki</creatorcontrib><creatorcontrib>Fukuda, Kuniaki</creatorcontrib><creatorcontrib>Hiyama, Takashi</creatorcontrib><creatorcontrib>Okumura, Toshiyuki</creatorcontrib><creatorcontrib>Sekino, Yuta</creatorcontrib><creatorcontrib>Mori, Kensaku</creatorcontrib><creatorcontrib>Takahashi, Hiroaki</creatorcontrib><creatorcontrib>Kikuchi, Shunsuke</creatorcontrib><title>Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy</title><title>Journal of oncology</title><addtitle>J Oncol</addtitle><description>Given the growing interest in using proton beam therapy (PBT) for hepatocellular carcinoma (HCC), it is possible that transarterial chemoembolization (TACE) could be used for selected patients who have previously undergone PBT. However, these cases can be technically challenging to treat and require appropriate preparation. Thus, we aimed to identify angiographic findings in this setting. We retrospectively identified 31 patients (28 men and 3 women, mean age: 69 years, range: 43–84 years) who underwent hepatic angiography plus TACE or transarterial infusion chemotherapy (TAI) for HCC that recurred after PBT (July 2007 to June 2018). We discovered four angiographic findings, which we speculate were related to the previous PBT. 18 patients experienced recurrence in the irradiated field, and 13 patients experienced recurrence outside the irradiated field. 29 patients underwent TACE and only 2 patients underwent TAI. The mean number of previous PBT treatments was 1.3 ± 0.6 (range: 1–4). The median interval from the earliest PBT treatment to hepatic angiography was 559 days (range: 34–5,383 days), and the median interval from the latest PBT treatment to hepatic angiography was 464 days (range: 34–5,383 days). Abnormal staining of the irradiated liver parenchyma was observed in 22 patients, which obscured the angiographic tumor staining in 4 patients. Development of a tortuous tumor feeder vessel was observed in 13 patients. Development of an extrahepatic collateral pathway was observed in 7 patients. Development of an arterioportal or arteriovenous shunt was observed in 4 patients. Based on these findings, we conclude that PBT was associated with various angiographic findings during subsequent transarterial chemotherapy for recurrent HCC, and familiarity with these findings will be important in developing appropriate treatment plans.</description><subject>Ablation</subject><subject>Angiography</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Chemoembolization</subject><subject>Chemotherapy</subject><subject>Development and progression</subject><subject>Hepatoma</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Medical imaging</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Patients</subject><subject>Tumors</subject><subject>Veins & arteries</subject><issn>1687-8450</issn><issn>1687-8450</issn><issn>1687-8469</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkc1rFDEYhwdRbK3ePEvAi6Br8_1xEdbFWqFgD9tzyGQyMykzyZrMtOx_b4Zd2-rJUwLvw-99H35V9RbBzwgxdo4hUueESUiEeladIi7FSlIGnz_5n1Svcr6FkFOo-MvqhCDCqETqtBrWofOxS2bXewsufGh86DLwAVybybswZXDvpx5cup2ZonXDMA8mgY1J1oc4GnCd3J2Pcx72YJucmVwDbnLJKIM4xQC-OjOCbe_Khv3r6kVrhuzeHN-z6ubi23Zzubr6-f3HZn21shyqaVVD1TJhCcY1cbQ2kvDaNA7XLSWNQdhRRWErIGdQ1qa2qmaMYieEolhYLslZ9eWQu5vr0TW2aCQz6F3yo0l7HY3Xf0-C73UX7zTnRHCuSsCHY0CKv2aXJz36vMib4IqrxriQVDIoCvr-H_Q2zikUPY0pFLzcitgj1ZnBaR_aWPbaJVSvOcQCSaiWuz8dKJtizsm1DycjqJey9VK2PpZd8HdPNR_gP-0W4OMB6Euv5t7_Z5wrjGvNI41kcWDkNzcmu8c</recordid><startdate>2019</startdate><enddate>2019</enddate><creator>Takei, Yohei</creator><creator>Iizumi, Takashi</creator><creator>Sakurai, Hideyuki</creator><creator>Minami, Manabu</creator><creator>Sakai, Masafumi</creator><creator>Hasegawa, Naoyuki</creator><creator>Fukuda, Kuniaki</creator><creator>Hiyama, Takashi</creator><creator>Okumura, Toshiyuki</creator><creator>Sekino, Yuta</creator><creator>Mori, Kensaku</creator><creator>Takahashi, Hiroaki</creator><creator>Kikuchi, Shunsuke</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8731-0081</orcidid></search><sort><creationdate>2019</creationdate><title>Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy</title><author>Takei, Yohei ; Iizumi, Takashi ; Sakurai, Hideyuki ; Minami, Manabu ; Sakai, Masafumi ; Hasegawa, Naoyuki ; Fukuda, Kuniaki ; Hiyama, Takashi ; Okumura, Toshiyuki ; Sekino, Yuta ; Mori, Kensaku ; Takahashi, Hiroaki ; Kikuchi, Shunsuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c609t-b09f57c322b3e4ba836bade2bf43da12e4940f706508babc9b5542e779427c683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Ablation</topic><topic>Angiography</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Chemoembolization</topic><topic>Chemotherapy</topic><topic>Development and progression</topic><topic>Hepatoma</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Medical imaging</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Patients</topic><topic>Tumors</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takei, Yohei</creatorcontrib><creatorcontrib>Iizumi, Takashi</creatorcontrib><creatorcontrib>Sakurai, Hideyuki</creatorcontrib><creatorcontrib>Minami, Manabu</creatorcontrib><creatorcontrib>Sakai, Masafumi</creatorcontrib><creatorcontrib>Hasegawa, Naoyuki</creatorcontrib><creatorcontrib>Fukuda, Kuniaki</creatorcontrib><creatorcontrib>Hiyama, Takashi</creatorcontrib><creatorcontrib>Okumura, Toshiyuki</creatorcontrib><creatorcontrib>Sekino, Yuta</creatorcontrib><creatorcontrib>Mori, Kensaku</creatorcontrib><creatorcontrib>Takahashi, Hiroaki</creatorcontrib><creatorcontrib>Kikuchi, Shunsuke</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takei, Yohei</au><au>Iizumi, Takashi</au><au>Sakurai, Hideyuki</au><au>Minami, Manabu</au><au>Sakai, Masafumi</au><au>Hasegawa, Naoyuki</au><au>Fukuda, Kuniaki</au><au>Hiyama, Takashi</au><au>Okumura, Toshiyuki</au><au>Sekino, Yuta</au><au>Mori, Kensaku</au><au>Takahashi, Hiroaki</au><au>Kikuchi, Shunsuke</au><au>Bilhim, Tiago</au><au>Tiago Bilhim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy</atitle><jtitle>Journal of oncology</jtitle><addtitle>J Oncol</addtitle><date>2019</date><risdate>2019</risdate><volume>2019</volume><issue>2019</issue><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>1687-8450</issn><eissn>1687-8450</eissn><eissn>1687-8469</eissn><abstract>Given the growing interest in using proton beam therapy (PBT) for hepatocellular carcinoma (HCC), it is possible that transarterial chemoembolization (TACE) could be used for selected patients who have previously undergone PBT. However, these cases can be technically challenging to treat and require appropriate preparation. Thus, we aimed to identify angiographic findings in this setting. We retrospectively identified 31 patients (28 men and 3 women, mean age: 69 years, range: 43–84 years) who underwent hepatic angiography plus TACE or transarterial infusion chemotherapy (TAI) for HCC that recurred after PBT (July 2007 to June 2018). We discovered four angiographic findings, which we speculate were related to the previous PBT. 18 patients experienced recurrence in the irradiated field, and 13 patients experienced recurrence outside the irradiated field. 29 patients underwent TACE and only 2 patients underwent TAI. The mean number of previous PBT treatments was 1.3 ± 0.6 (range: 1–4). The median interval from the earliest PBT treatment to hepatic angiography was 559 days (range: 34–5,383 days), and the median interval from the latest PBT treatment to hepatic angiography was 464 days (range: 34–5,383 days). Abnormal staining of the irradiated liver parenchyma was observed in 22 patients, which obscured the angiographic tumor staining in 4 patients. Development of a tortuous tumor feeder vessel was observed in 13 patients. Development of an extrahepatic collateral pathway was observed in 7 patients. Development of an arterioportal or arteriovenous shunt was observed in 4 patients. Based on these findings, we conclude that PBT was associated with various angiographic findings during subsequent transarterial chemotherapy for recurrent HCC, and familiarity with these findings will be important in developing appropriate treatment plans.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>31354819</pmid><doi>10.1155/2019/3580379</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8731-0081</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Ablation Angiography Cancer Care and treatment Chemoembolization Chemotherapy Development and progression Hepatoma Liver Liver cancer Medical imaging Medical research Medicine, Experimental Patients Tumors Veins & arteries |
title | Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy |
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