الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 138 |  |  |
| | | from | 138 | | |
Abstract
Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally, with 854,000 new cases and 810,000 deaths per year, accountine for 7% of all cancers
Hepatocellular carcinoma (HCC) represents about 90% of primary liver cancers and constitutes a major global health problem. The incidence of HCC increases progressively with advancing age in all populations, reaching a peak at 70 years.
Several treatments for HCC have been developed during the past 2 decades. Surgical resection is generally believed to be the standard form of curative therapy; however, it is possible only in a small subgroup of patients because of the presence of multifocal tumors or compromised hepatic reserve at diagnosis. Liver transplantation is another treatment option, especially for patients with advanced cirrhosis, but patients on the waiting list for transplantation far outnumber potential cadaveric or living hepatic donors.
Among the various non-surgical interventions, percutaneous ultrasound-guided therapy, including injection of ethanol or acetic acid, and thermal ablation using radiofrequency or microwave energy, are the main- stays of current clinical practice. These therapies have the advantages of preserving unaffected liver parenchyma, and avoiding potential complications from major liver surgery. Numerous studies have shown that these methods may prolong survival in patients with unresectable HCC, and combination therapy with these various approaches may also enhance treatment responses.
Hepatic artery obstruction is performed during an angiographic procedure and is known as trans-arterial, or trans-catheter arterial embolization (TAE). When TAE is combined with the prior injection into the hepatic artery of chemotherapeutic agents, usually mixed with lipiodol, the procedure is known as trans-arterial chemoembolization (TACE).
The procedure requires the advancement of the catheter into the hepatic artery and then to lobar and segmental branches aiming to be as selective as possible so as to induce only minimal injury to the surrounding non-tumorous liver. .
Because HCC has its specific etiologies, epidemiology, clinical problems, treatments, and disease progression, generic plus disease-specific measures are essential to provide a comprehensive picture of HRQOL.
Compromised HRQOL has been shown in patients with liver disease including cirrhosis or hepatitis virus, in part a consequence of severe symptoms, treatment and side effects, and burden of disease.
HRQOL increasingly is considered an important end point in cancer clinical trials and clinical care, along with the traditional end points such as tumor response rate and survival time or rate.
Comparison with patients with chronic liver disease.
Patients with HCC had worse physical well-being and overall HRQOL than patients with chronic liver disease, mainly in terms of pain, loss of appetite and weight, difficulties digesting food, and decreased ability to perform usual activities.
Comparison with general population.
Patients with HCC had lower HRQOL than the general population, especially in physical, psychological, functional well-being, and hepatobiliary symptoms.
This prospective not randomized study at two tertiary center ( minia university hospital and minia oncology center . informed consent obtained in every case . a tumor board made the therapy decision based on clinical factor , imaging , comorbidities and BCLC classifications .
This study included 99 patients with hepatocellular carcinoma (HCC) on top of hepatitis C virus ( HCV ) and hepatitis B virus related cirrhosis
Aim of the work is to Evaluate the efficacy of radiofrequency and transarterial chemoembolization on the clinical , laboratory profile and quality of life of patient with HCC .
Then we found that :
There is significant decrease of SGPT after the procedure .
There is significant decrease of SGOT after the procedure .
There is non significant changes of albumin after the procedure .
There is significant decrease of bilirubin after the procedure.
There is significant decrease of AFP after the procedure.
There is significant good changes in all domains of quality of life in included patient after one month of the procedure .
Conclusion :
HCC treatment with Radiofrequency or TACE had a great impact on patients health related quality of life.