Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,which poses significant challenges due to its complex progression and limited curative options.Transarterial chemoembolization...Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,which poses significant challenges due to its complex progression and limited curative options.Transarterial chemoembolization(TACE)is a cornerstone treatment for intermediate-stage HCC,as outlined in widely accepted clinical guidelines,including the Barcelona Clinic Liver Cancer(BCLC)framework.Over the years,TACE has evolved through technological innovations and novel therapeutic combinations designed to enhance efficacy and improve patient outcomes.Recent advancements include refined imaging techniques,innovative embolic materials,and the integration of systemic therapies such as tyrosine kinase inhibitors and immune checkpoint inhibitors.These advancements have expanded TACE’s applicability and improved its efficacy in controlling tumor progression and prolonging survival in patients with unresectable HCC.Despite these advancements,challenges persist,including the optimization of treatment protocols,the management of complications,and the need for personalized treatment strategies that are tailored to diverse patient populations.This review highlights the latest progress and current understanding of TACE as a therapeutic modality for HCC.It also explores emerging trends,ongoing challenges,and the potential for novel combinations to redefine the therapeutic landscape.By synthesizing the latest evidence,this article aims to provide valuable insights for clinicians and researchers striving to improve HCC management and patient outcomes.展开更多
Platinum-based chemotherapy,a cornerstone in the treatment of various malignancies,is often limited by its potential cardiotoxic effects.Understanding these effects is crucial for optimizing patient outcomes and guidi...Platinum-based chemotherapy,a cornerstone in the treatment of various malignancies,is often limited by its potential cardiotoxic effects.Understanding these effects is crucial for optimizing patient outcomes and guiding treatment decisions.This review explores the mechanisms,clinical manifestations,detection,management,and future directions in the research of cardiotoxicity associated with platinum-based chemotherapy.The mechanisms discussed here include oxidative stress,reactive oxygen species production,DNA damage,and alterations in signaling pathways.Clinical manifestations range from mild symptoms to severe complications,including Takotsubo cardiomyopathy,as highlighted by recent case studies.The role of diagnostic tools such as echocardiography,cardiac magnetic resonance imaging,and cardiac biomarkers in early detection is emphasized,underscoring the importance of regular cardiac monitoring.Management strategies focus on cardioprotective agents,alternative chemotherapy regimens,and emerging therapeutic approaches,including the potential of nano liposomal and cubosomal formulations.The review also delves into the future of personalized medicine in predicting and managing cardiotoxicity,advocating for ongoing research to mitigate these adverse effects.This comprehensive overview aims to enhance the understanding of cardiotoxicity in platinum-based chemotherapy,informing clinical practices and promoting patient-centric care.展开更多
文摘Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,which poses significant challenges due to its complex progression and limited curative options.Transarterial chemoembolization(TACE)is a cornerstone treatment for intermediate-stage HCC,as outlined in widely accepted clinical guidelines,including the Barcelona Clinic Liver Cancer(BCLC)framework.Over the years,TACE has evolved through technological innovations and novel therapeutic combinations designed to enhance efficacy and improve patient outcomes.Recent advancements include refined imaging techniques,innovative embolic materials,and the integration of systemic therapies such as tyrosine kinase inhibitors and immune checkpoint inhibitors.These advancements have expanded TACE’s applicability and improved its efficacy in controlling tumor progression and prolonging survival in patients with unresectable HCC.Despite these advancements,challenges persist,including the optimization of treatment protocols,the management of complications,and the need for personalized treatment strategies that are tailored to diverse patient populations.This review highlights the latest progress and current understanding of TACE as a therapeutic modality for HCC.It also explores emerging trends,ongoing challenges,and the potential for novel combinations to redefine the therapeutic landscape.By synthesizing the latest evidence,this article aims to provide valuable insights for clinicians and researchers striving to improve HCC management and patient outcomes.
文摘Platinum-based chemotherapy,a cornerstone in the treatment of various malignancies,is often limited by its potential cardiotoxic effects.Understanding these effects is crucial for optimizing patient outcomes and guiding treatment decisions.This review explores the mechanisms,clinical manifestations,detection,management,and future directions in the research of cardiotoxicity associated with platinum-based chemotherapy.The mechanisms discussed here include oxidative stress,reactive oxygen species production,DNA damage,and alterations in signaling pathways.Clinical manifestations range from mild symptoms to severe complications,including Takotsubo cardiomyopathy,as highlighted by recent case studies.The role of diagnostic tools such as echocardiography,cardiac magnetic resonance imaging,and cardiac biomarkers in early detection is emphasized,underscoring the importance of regular cardiac monitoring.Management strategies focus on cardioprotective agents,alternative chemotherapy regimens,and emerging therapeutic approaches,including the potential of nano liposomal and cubosomal formulations.The review also delves into the future of personalized medicine in predicting and managing cardiotoxicity,advocating for ongoing research to mitigate these adverse effects.This comprehensive overview aims to enhance the understanding of cardiotoxicity in platinum-based chemotherapy,informing clinical practices and promoting patient-centric care.
