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| 1 | Locally advanced nasopharyngeal carcinoma:Current and emerging treatment strategies显示文摘Although nasopharyngeal carcinoma(NPC)is a widespread malignant tumor,it is particularly frequent in Southeast Asia.Although T1 tumors can be effectively controlled with exclusive radiotherapy,this treatment modality is insufficient for most NPC patients,who present with locally advanced disease at diagnosis.In fact,for stages ranging from T2b N0 to T4 N3,definitive scientific evidence supports the use of concurrent platinum-based chemotherapy with standard external beam radiotherapy.This treatment approach has shown a statistically significant advantage in terms of overall survival,with respect to radiotherapy alone.Several trials have also investigated the use of neoadjuvant and adjuvant chemotherapy in combination with radiotherapy or chemo-radiotherapy.Platinum compounds,anthracyclines and taxanes are among the chemotherapy agents employed.This review focuses on the clinical results obtained in the field of adjuvant/concurrent/neoadjuvant chemotherapy for locally advanced NPC,for which exclusive concurrent chemo-radiotherapy currently represents the standard treatment approach. | Francesco Perri Davide Bosso Carlo Buonerba Giuseppe Di Lorenzo Giuseppina Della Vittoria Scarpati | 2011 | World Journal of Clinical Oncology2011，2，12： | 24 |
| 2 | Combined chemo-radiotherapy in locally advanced nasopharyngeal carcinomas显示文摘AIM:To provide efficacy and safety data about the combined use of radiotherapy and chemo-radiotherapy in nasopharyngeal carcinoma(NPC).METHODS:We reviewed data of 40 patients with locally advanced NPC treated with induction chemotherapy followed by concomitant chemo-radiotherapy(CCRT)(22/40 patients)or CCRT alone(18/40)from March 2006 to March 2012.Patients underwent fiberoscopy with biopsy of the primitive tumor,and computed tomography scan of head,neck,chest and abdomen with and without contrast.Cisplatin was used both as induction and as concomitant chemotherapy,while 3D conformal radiation therapy was delivered to the nasopharynx and relevant anatomic regions(total dose,70 Gy).The treatment was performed using 6 MV photons of the linear accelerator administered in 2 Gy daily fraction for five days weekly.This retrospective analysis was approved by the review boards of the participating institutions.Patients gave their consent to treatment and to anonymous analysis of clinical data.RESULTS:Thirty-three patients were males and 7 were females.Median follow-up time was 58 mo(range,1-92 mo).In the sub-group of twenty patients with a follow-up time longer than 36 mo,the 3-year survival and disease free survival rates were 85%and 75%,respectively.Overall response rate both in patients treated with induction chemotherapy followed by CCRT and in those treated with CCRT alone was 100%.Grade 3 neutropenia was the most frequent acute side-effect and it occurred in 20 patients.Grade 2 mucositis was seen in 29 patients,while grade 2 xerostomia was seen in 30 patients.Overall toxicity was manageable and it did not cause any significant treatment delay.In the whole sample population,long term toxicity included grade 2 xerostomia in 22 patients,grade 1 dysgeusia in 17 patients and grade 1 subcutaneous fibrosis in 30 patients.CONCLUSION:Both CCRT and induction chemotherapy followed by CCRT showed excellent activity in locally advanced NPC.The role of adjuvant chemotherapy remains to be defined. | Francesco Perri Giuseppina Della Vittoria Scarpati Carlo Buonerba Giuseppe Di Lorenzo Francesco Longo Paolo Muto Concetta Schiavone Fabio Sandomenico Francesco Caponigro | 2013 | World Journal of Clinical Oncology2013，4，2： | 22 |
| 3 | Efficacy of rituximab in gastric diffuse large B cell lymphoma patients显示文摘AIM:To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma(DLBCL).METHODS:Sixty patients(median age:58 years)with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007,were included in this analysis.Patients were selected by stage (Ⅰ-Ⅳ,Lugano staging system),European Cooperative Oncology Group performance status(0-2)and treatment strategies.Treatment strategies were chemotherapy alone(group A,n=30)[scheduled as cyclophosphamide,doxorubicin,vincristine and prednisone (CHOP)and CHOP-like],and chemotherapy combined with rituximab(group B,n=30).The primary end point of the study was complete response(CR)rate;the secondary end points were disease-free survival (DFS)at 5 years and overall survival(OS).RESULTS:Median follow-up was 62 mo(range:31102 mo).We observed a significant difference between the two groups(A vs B)in terms of CR[76.6%(23/30) vs 100%,P=0.04)and DFS at 5 years[73.3%(22/30) vs 100%,P=0.03).To date,19 group A(63.3%) patients are alive and 11 have died,while all group B patients are alive.No significant differences in toxicity were observed between the two groups.CONCLUSION:Rituximab in combination with chemotherapy improves CR rate,DFS and OS.Further prospective trials are needed to confirm our results. | Davide Leopardo Giuseppe Di Lorenzo Amalia De Renzo Piera Federico Serena Luponio Carlo Buonerba Elide Matano Gerardina Merola Martina Imbimbo Enzo Montesarchio Antonio Rea Maria Carmela Merola Sabino De Placido Giovannella Palmieri | 2010 | World Journal of Gastroenterology2010，16，20： | 19 |
| 4 | Performance of liver stiffness measurements by transient elastography in chronic hepatitis显示文摘AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published meta-analysis.METHODS:This was a single center cross-sectional study.Consecutive patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were enrolled.TE was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case procedure.Fibrosis was staged according to the Metavir scoring system.The diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve analysis.RESULTS:Two hundred and fifty-two patients met the inclusion criteria.Six(2%) patients were excluded due to unreliable TE measurements.Thus,246(171 men and 75 women) patients were analyzed.One hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency virus.ROC curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies. | Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano Filice Carlo Filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti Paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone Lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma Paolo Sacchi Domenico Zanaboni Marco Zaramella | 2013 | World Journal of Gastroenterology2013，19，1： | 18 |
| 5 | Chronic hepatitis C:This and the new era of treatment显示文摘Over the last years it has started a real revolution in the treatment of chronic hepatitis C. This occurred for the availability of direct-acting antiviral agents that allow to reach sustained virologic response in approximately 90% of cases. In the near future further progress will be achieved with the use of pan-genotypic drugs with high efficacy but without side effects. | Gaetano Bertino Annalisa Ardiri Maria Proiti Giuseppe Rigano Evelise Frazzetto Shirin Demma MariaIrene Ruggeri Laura Scuderi Giulia Malaguarnera Nicoletta Bertino Venerando Rapisarda Isidoro Di Carlo Adriana Toro Federico Salomone Mariano Malaguarnera Emanuele Bertino Michele Malaguarnera | 2016 | World Journal of Hepatology2016，8，2： | 10 |
| 6 | Long-term alpha interferon and lamivudine combination therapy in non-responder patients with anti-HBe-positive chronic hepatitis B:Results of an open,controlled trial显示文摘AIM: To investigate the safety and efficacy of long-term combination therapy with alpha interferon and lamivudine in non-responsive patients with anti-HBe-positive chronic hepatitis B.METHODS: 34 patients received combination treatment (1 month lamivudine, 12 month lamivudine+interferon, 6month lamivudine), 24 received lamivudine (12 months),24 received interferon (12 months). Interferon was administered at 6 MU tiw and lamivudine at 100 mg orally once daily. Patients were followed up for 6 months after treatment.RESULTS: At the end of treatment, HBV DNA negativity rates were 88 % with lamivudine+interferon, 99 % with lamivudine and 55 % with interferon, (P=0.004, combination therapy vs. interferon, and P=0.001 lamivudine vs.interferon), and serum transaminase normalization rates were 84 %, 91% and 53 % (P=0.01 combination therapy vs. interferon, and P=0.012 lamivudine vs. interferon). Six months later, HBV DNA negativity rates were 44 % with lamivudine+interferon, 33 % with lamivudine and 25 % with interferon, and serum transaminase normalization rates were 61%, 42 % and 45 %, respectively, without statistical significance. No YMDD variants were observed with lamivudine+interferon (vs. 12 % with lamivudine). The combination therapy appeared to be safe. CONCLUSION: Although viral clearance and transaminase normalization are slower with long-term lamivudine+interferon than that with lamivudine alone, the combination regimen seems to provide more lasting benefits and to protect against the appearance of YMDD variants. Studies with other regimens regarding sequence and duration are needed. | M. Francesca Jaboli Carlo Fabbri Stefania Liva Francesco Azzaroli Giovanni Nigro Silvia Giovanelli Francesco Ferrara Anna Miracolo Sabrina Marchetto Marco Montagnani Antonio Colecchia Davide Festi Letizia Bacchi Reggiani Enrico Roda Giuseppe Mazzella | 2003 | World Journal of Gastroenterology2003，9，7： | 10 |
| 7 | Comparative study of laparoscopic vs open gastrectomy in gastric cancer management显示文摘AIM:To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrec-tomy in a single unit.METHODS:From February 2000 to September 2004,all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial.Primary endpoint was cancer-related survival and secondary endpoints were overall survival,evaluation of surgical complications and mortality.RESULTS:Fifty-eight patients were enrolled.Forty-seven patients were followed-up(range 11-103,me-dian 38 mo).Four patients were lost at follow up.Twenty-two patients underwent a laparoscopic gastric surgery(LGS)and 25 had a standard open procedure(OGS).No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate(50% vs 52%,P = 1),and 5 years overall mortal-ity rate(54.5% vs 56%,P = 1).Accordingly,cancer-related and overall survival probability by Kaplan-Meier method showed comparable results(P = 0.81 and P = 0.83,respectively).We found no differences in surgical complications in the 2 groups.There was no conversion to open surgery in this series.CONCLUSION:LGS is as effective as OGS in the man-agement of advanced gastric cancer.However LGS can-not be recommended routinely over OGS for the treat-ment of advanced gastric cancer. | Giuseppe S Sica Edoardo Iaculli Livia Biancone Sara Di Carlo Rosa Scaramuzzo Cristina Fiorani Paolo Gentileschi Achille L Gas-pari | 2011 | World Journal of Gastroenterology2011，17，41： | 9 |
| 8 | Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma显示文摘BACKGROUND: Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation. METHODS: One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study. Among them, 87 underwent surgical resection, and 53 underwent percutaneous radiofrequency ablation. Patient charac-teristics, survival, and recurrence-free survival were analyzed. RESULTS: Recurrence-free survival was longer in the resection group in comparison to the radiofrequency group with a median recurrence-free time of 36 versus 26 months, respectively (P=0.01, HR=1.52, 95% CI: 1.05-2.25). In the resection group, median survival was 46 months, with the 1-, 3- and 5-year survival rates of 89.7%, 72.4% and 40.2%. In the radiofrequency group, median survival was 32 months, with the 1-, 3- and 5-year survival rates of 83.0%, 43.4% and 22.6% (P<0.01). CONCLUSIONS: Surgical resection improves the overall survival and recurrence-free survival in comparison with radiofrequency ablation. New evidences are needed to define the real role of the percutaneous technique as an alternative to surgery. | Amilcare Parisi Jacopo Desiderio Stefano Trastulli Elisa Castellani Rosario Pasquale Roberto Cirocchi Carlo Boselli Giuseppe Noya | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，3： | 8 |
| 9 | Optimal management of a patient with recurrent nasopharyngeal carcinoma显示文摘Nasopharyngeal carcinoma is rare in western countries, accounting for less than 1% of all malignancies. Despite prognosis is satisfactory for newly diagnosed, non-metastatic disease, management of recurrent disease is challenging, with a survival expectancy of approximately 6 mo with the use of chemotherapy as the sole salvage treatment. We report a case of recurrent nasopharyngeal carcinoma treated with a combination of chemotherapy, radiotherapy and surgery in the context of a multidisciplinary approach. A durable complete response was achieved. | Francesco Perri Italo Dell’Oca Paolo Muto Concetta Schiavone Corrado Aversa Franco Fulciniti Raffaele Solla Giuseppina Della Vittoria Scarpati Carlo Buonerba Giuseppe Di Lorenzo Francesco Caponigro | 2014 | World Journal of Clinical Cases2014，2，7： | 8 |
| 10 | Treatment of peri-anal fistula in Crohn's disease显示文摘Anal fistulas are a common manifestation of Crohn's disease(CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently em-ployed. However, at the moment, none of these tech-niques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medi-cal therapy and those causing disabling symptoms. Ut-most attention should be paid to correcting the balance between eradication of the fistula and the preservationof fecal continence. | Giuseppe S Sica Sara Di Carlo Giorgia Tema Fabrizio Montagnese Giovanna Del Vecchio Blanco Valeria Fiaschetti Giulia Maggi Livia Biancone | 2014 | World Journal of Gastroenterology2014，20，37： | 8 |
| 11 | Treatment-related gastrointestinal toxicities and advanced colorectal or pancreatic cancer:A critical update显示文摘Gastrointestinal toxicities(GIT), including oral mucositis,nausea and vomiting, and diarrhea, are common side effects of chemotherapy and targeted agents in patients with advanced colorectal cancer and pancreatic cancer. Being often underreported, it is still difficult to precisely establish their burden in terms of both patient's quality of life and cancer care costs. Moreover, with the use of more intensive upfront combination regimens, the frequency of these toxicities is rapidly growing with a potential negative effect also on patient's outcome, as a result of dose reductions, delays or even discontinuation of active treatments. Thus, identifying patients at higher risk of developing GIT as well as an optimal management are paramount in order to improve patient's compliance and outcome. After the description of the main treatment-induced GIT, we discuss the current knowledge on the pathophysiology of these side effects and comment the scales commonly used to assess and grade them. We then provide a critical update on GIT incidence based on the results of key randomized trials conducted in patients with metastatic colorectal cancer and advanced pancreatic cancer. | Giuseppe Aprile Karim Rihawi Elisa De Carlo Stephen T Sonis | 2015 | World Journal of Gastroenterology2015，21，41： | 7 |
| 12 | Moving forward in the treatment of cholangiocarcinoma显示文摘Despite being the second most frequent primary liver tumor in humans,early diagnosis and treatment of cholangiocarcinoma(CCA)are still unsatisfactory.In fact,survival after 5 years is expected in less than one fourth of patients diagnosed with this disease.Rare incidence,late appearance of symptoms and heterogeneous biology are all factors contributing to our limited knowledge of this cancer and determining its poor prognosis in the clinical setting.Several efforts have been made in the last decades in order to achieve an improved classification/understanding with regard to the diverse CCA forms.Location within the biliary tree has helped to distinguish between intrahepatic,perihilar and distal CCA types.Sequence analysis contributed to identifying several characteristic genetic aberrations in CCA that may also serve as possible targets for therapy.Novel findings are expected to significantly improve the management of this malignancy in the near future.In this changing scenario our review focuses on the current and future strategies for CCA treatment.Both systemic and surgical treatments are discussed in detail.The results of the main studies in this field are reported,together with the ongoing trials.The current findings suggest that an integrated multidisciplinary approach to this malignancy would be helpful to improve its outcome. | Tommaso M Manzia Alessandro Parente Ilaria Lenci Bruno Sensi Martina Milana Carlo Gazia Alessandro Signorello Roberta Angelico Giuseppe Grassi Giuseppe Tisone Leonardo Baiocchi | 2021 | World Journal of Gastrointestinal Oncology2021，13，12： | 6 |
| 13 | Long lasting response to second-line everolimus in kidney cancer显示文摘In the case presented here, everolimus was administered after first line therapy with sunitinib in a patient with metastatic renal cell carcinoma. The safety profile was excellent. The prolonged progression-free survival(PFS) obtained with everolimus in this case is of peculiar interest, as it is a multiple of the median PFS obtained in with everolimus in the regulatory trial. Such finding suggests that a subset of patients with renal cell carcinma may particularly benefit from everolimus. | Antonella Virtuoso Tania Policastro Michela Izzo Piera Federico Carlo Buonerba Pasquale Rescigno Giuseppe Di Lorenzo | 2013 | World Journal of Clinical Cases2013，1，5： | 6 |
| 14 | Anaplastic thyroid carcinoma:A comprehensive review of current and future therapeutic options显示文摘Anaplastic thyroid carcinoma(ATC)is the rarest,but deadliest histologic type among thyroid malignancies,with a dismal median survival of 3-9 mo.Even though ATC accounts for less than 2%of all thyroid tumors,it is responsible for 14%-39%of thyroid carcinoma-related deaths.ATC clinically presents as a rapidly growing mass in the neck,associated with dyspnoea,dysphagia and vocal cord paralysis.It is usually locally advanced and often metastatic at initial presentation.For operable diseases,the combination of radical surgery with adjuvant radiotherapy or chemotherapy,using agents such as doxorubicin and cisplatin,is the best treatment strategy.Cytotoxic drugs for advanced/metastatic ATC are poorly effective.On the other hand,targeted agents might represent a viable therapeutic option.Axitinib,combretastatin A4,sorafenib and imatinib have been tested in small clinical trials of ATC,with a promising disease control rate ranging from 33%to 75%.Other clinical trials of targeted therapy for thyroid carcinoma are currently ongoing.Biological agents that are under investigation include pazopanib,gefitinib and everolimus.With the very limited therapeutic armamentarium available at the present time,targeted therapy constitutes an exciting new horizon for ATC.In future,biological agents will probably represent the standard of care for this aggressive malignancy,in the same fashion as it has recently occurred for other chemo-refractory tumors,such as kidney and hepatic cancer. | Francesco Perri Giuseppe Di Lorenzo Giuseppina Della Vittoria Scarpati Carlo Buonerba | 2011 | World Journal of Clinical Oncology2011，2，3： | 5 |
| 15 | Hepatocellular carcinoma and the risk of occupational exposure显示文摘Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem. | Venerando Rapisarda Carla Loreto Michele Malaguarnera Annalisa Ardiri Maria Proiti Giuseppe Rigano Evelise Frazzetto Maria Irene Ruggeri Giulia Malaguarnera Nicoletta Bertino Mariano Malaguarnera Vito Emanuele Catania Isidoro Di Carlo Adriana Toro Emanuele Bertino Dario Mangano Gaetano Bertino | 2016 | World Journal of Hepatology2016，8，13： | 5 |
| 16 | Role of three-dimensional imaging integration in atrial fibrillation ablation显示文摘Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form,catheter ablation aimed at electrically disconnecting the pulmonary veins(PVs) has proved more effective than use of antiarrhythmic drugs in maintaining sinus rhythm during follow-up.On the other hand,this ablation procedure is complex,requires specific training and adequate clinical experience.A main challenge is represented by the need for accurate sequential positioning of the ablation catheter around each veno-atrial junction to deliver point-by-point radiofrequency energy applications in order to achieve complete and persistent electrical disconnection of the PVs.Imaging integration is a new technology that enables guidance during this procedure by showing a three-dimensional,pre-acquired computed tomography or magnetic resonance image and the relative real-time position of the ablation catheter on the screen of the electroanatomic system.Reports in the literature suggest that imaging integration provides accurate visual information with improvement in the procedure parameters and/or clinical outcomes of the procedure. | Roberto De Ponti Raffaella Marazzi Domenico Lumia Giuseppe Picciolo Roberto Biddau Carlo Fugazzola Jorge A Salerno-Uriarte | 2010 | World Journal of Cardiology2010，2，8： | 5 |
| 17 | When sepsis affects the heart: A case report and literature review显示文摘A 59-year-old nursing home patient with Down syndrome was brought to the internal medicine department of our hospital due to fever, cough without expectorate, and dyspnea. A thoracic computed tomography revealed the presence of bilateral basal parenchymal opacities. Her condition deteriorated after admission and troponin reached a peak serum concentration of 16.9 ng/m L. The patient was in cardiogenic shock. In addition to fluid resuscitation, vaso-active amine infusion was administered to achieve hemodynamic stabilization. The differential diagnosis investigated possible pulmonary embolism, myocardial infarction, and myocarditis. Furthermore, a second transthoracic echocardiogram suggested Tako-Tsubo syndrome. This is a septic patient. The purpose of this manuscript is to review studies which formerly examined the possible association between high levels of troponin and mortality to see if it can be considered a positive predictive factor of fatal prognosis as the case of thrombocytopenia, already a positive independent predictive factor of multiple organ failure syndrome, and generally to characterize risk profile in a septic patient. | Giuseppe Clemente Antonino Tuttolomondo Daniela Colomba Rosaria Pecoraro Chiara Renda Vittoriano Della Corte Carlo Maida Irene Simonetta Antonio Pinto | 2015 | World Journal of Clinical Cases2015，3，8： | 5 |
| 18 | Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: A systematic review and meta-analysis显示文摘 | Roberto Cirocchi Eriberto Farinella Stefano Trastulli Jacopo Desiderio Chiara Listorti Carlo Boselli Amilcare Parisi Giuseppe Noya Jayesh Sagar | 2012 | Surgical Oncology2012，，： | 4 |
| 19 | Transarterial radioembolization for hepatocellular carcinoma:An update and perspectives显示文摘In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma(HCC),both in terms of disease control and tolerability profile.This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound(usually Yttrium90),and exerts its therapeutic effect through the radiation carried by these microspheres.A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications.Radioembolization is a technically complex and expensive technique,which has only recently entered clinical practice and is supported by scant results from phase Ⅲ clinical trials.Nevertheless,it may represent a valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCC patients,as shown by a comparative retrospective assessment that reported a longer time to progression,but not of overall survival,and a more favorable safety profile for radioembolization.In addition,this treatment has reported a higher percentage of tumor shrinkage,if compared to TACE,for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery.Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib. | Rodolfo Sacco Valeria Mismas Sara Marceglia Antonio Romano Luca Giacomelli Marco Bertini Graziana Federici Salvatore Metrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Ambra Corti Manuel Tredici Michele Piccinno Luigi Giorgi Carlo Bartolozzi Irene Bargellini | 2015 | World Journal of Gastroenterology2015，21，21： | 4 |
| 20 | Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients显示文摘AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviraltherapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ 2M H = 4, P < 0.04). In fact, LS ≥ 9.5 was significantly higher in co-infected than in HIV and HCV mono-infected pa-tients (χ 2 = 5, P < 0.03). Also APRI and the FIB-4 index showed more LF in co-infected than in HIV mono-infect-ed patients (P < 0.0001), but not in HCV mono-infected patients. In HIV?HCV co-infected patients, the extent of LS was significantly associated with alcohol intake (P < 0.04) and lower CD4+ cell count (P < 0.02). In HCV pa-tients, LS was correlated with alcohol intake (P < 0.001) and cholesterol levels (P < 0.03). Body mass index, dia-betes, HCV-and HIV-viremia were not significantly cor-related with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were < 400 cells/mm 3 and LS was > 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protective immunological effects of HAART on LF progression outweigh its hepatotoxic effects. | Valentina Li Vecchi Maurizio Soresi Claudia Colomba Giovanni Mazzola Pietro Colletti Maurizio Mineo Paola Di Carlo Emanuele La Spada Giovanni Vizzini Giuseppe Montalto | 2010 | World Journal of Gastroenterology2010，16，41： | 4 |
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