Combination with Hyperthermia and Chemotherapy: Liver Cancer
In liver cancer, there are two kinds of liver cancer. One is a primary hepatocellular carcinoma and the other is metastatic liver cancer.
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Combination with Hyperthermia and Chemotherapy: Liver Cancer Satoshi Kokura
Abstract In liver cancer, there are two kinds of liver cancer. One is a primary hepatocellular carcinoma and the other is metastatic liver cancer. As for the out-of case of a surgery indication of these cancers, administrations into the hepatic artery of an anticancer agent, an arterial-embolism treatment (TACE), RFA, transient embolization by Degradable Starch Microspheres with anticancer agent or systemic chemotherapy are performed. At present, liver resection and transplantation can improve the survival rate of HCC, but long waiting time due to the shortage of donor organs may result in tumor progression. Given these limitations, many nonsurgical methods have been proposed. However, in each monotherapy of these, the curative effect is restrictive and a multidisciplinary treatment is needed. In these cases, the combined effect of hyperthermia is very high. Keywords Chemoembolization • Systemic chemotherapy • Nanoparticle • Immunotherapy
25.1
Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the forth of male and sixth of female leading tumor in Japan, and it is estimated that its incidence will continue to rise in coming decades [1, 2]. Approximately 85 % of HCC is accompanied by cirrhosis, which works together with HCC leading to liver functional failure [3]. The pathogenesis for HCC is rather complicated since many risk factors are involved. The some risk factors are hepatitis B and aflatoxin in East Asia and Central Africa account for about 80 % of all cases [4–6], whereas hepatitis C and alcohol are risk factors in North America, Europe and Japan [7, 8]. The risk of carcinogenesis further increases with progression to hepatic cirrhosis in all liver disorders. Hepatic
S. Kokura (*) Kokura Lab. Faculty of Health and Medical Sciences, Kyoto Gakuen University, 18, Gotanda-cho, Yamanouchi, Ukyo-ku, Kyoto-shi, Kyoto 615-8577, Japan e-mail: [email protected] © Springer Science+Business Media Singapore 2016 S. Kokura et al. (eds.), Hyperthermic Oncology from Bench to Bedside, DOI 10.1007/978-981-10-0719-4_25
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cirrhosis is an irreversible pathological change and inhibition of disease progression has previously been considered difficult. At present, liver resection and transplantation can improve the survival rate of HCC, but long waiting time due to the shortage of donor organs may result in tumor progression. Given these limitations, many nonsurgical methods have been proposed.
25.2
Treatment Argorism of Hepatocellular Carcinoma
The Consensus-Based Clinical Practice Guidelines had proposed by the Japan Society of Hepatology (JSH) at 2010 version in Japan, and recently they have revised, updated (Fig. 25.1). No new treatments or molecular targeted agents have been developed for HCC since the 2010 JSH consensus-based treatment algorithm [9, 10] was adopted, so few changes were made to 2014 version. Although sorafenib is recommended for patients with minor portal vein invasion or portal invasion at t
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