2 research outputs found
Three-Dimensional Conformal Radiotherapy for Hepatocellular Carcinoma in Patients Unfit for Resection, Ablation, or Chemotherapy: A Retrospective Study
Purpose. The purpose is to evaluate the feasibility, efficacy, and the toxicity of three-dimensional conformal radiotherapy (3DCRT) in patients with advanced hepatocelluar carcinoma (HCC) and inferior vena cava tumor thrombosis (IVCTT). Methods. Between 2007 and 2012, in a retrospective way, 9 patients (median age 69 years) with advanced HCC and IVCTT unfit for surgery, radiofrequency ablation, embolization, or chemotherapy were treated with three-dimensional conformal radiotherapy (3DCRT). The radiotherapy volume included both primary tumor and IVTT. The radiotherapy schedule was 50–52 Gy in 2 Gy fractions. Overall survival (OS), response to radiotherapy, visual analogue scale (VAS), and toxicity were assessed. Results. All patients demonstrated a response rate up to 60%. During radiotherapy, 3 patients experienced grade 1 nausea/vomit toxicity. All patients demonstrated an elevation of the liver enzymes (3 patients with grade 1 and 6 patients with grade 2). The mean VAS-score was decreased from 6.11 to 3.11, while the median overall survival was 24 months. Conclusion. 3DCRT achieves a very high local control rate and is suitable for patients with HCC and IVTT, while the documented radiation induced toxicity is moderate. It can be recommended for palliation in patients unable to undergo curative therapies
Retrograde Transpopliteal Approach of Iliofemoral Lesions
Purpose: Aim of this study is to present our initial experience with the
use of the retrograde popliteal artery access in patients with certain
anatomic lesions. Methods: Between September 2008 and September 2010, 24
patients underwent a transpopliteal retrograde subintimal
recanalization. Instead of its usage when antegrade recanalization
failed, the “facedown” technique was preferred as a first choice in
patients with common femoral artery stenosis or occlusion, proximal
lesions of the superficial femoral artery (SFA) with no stump, severe
obesity, tandem iliac, and SFA lesions. Results: Technical success was
achieved in 91.7% of patients.The complication rate was 12.5%. The
primary patency at 6, 12, and 18 months was 86.4%, 65.8%, and 65.8%,
respectively. Conclusions: The retrograde popliteal artery approach can
be considered as the primary SFA recanalization strategy in carefully
selected patients, with competitive immediate and midterm results