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  1. M.Debyanti1,Sudarmanta2,Y.Supriatna2 1Resident and 2Staff of Radiology Departement, Faculty of Medicine, Universitas Gadjah Mada and Sardjito General Hospital 4th – 6th May 2017, Indonesian Society of Radiology Annual Scientific Meeting XII Yogyakarta
  2. • Most common malignancies in Asia • Prevalence and incidence >>> HEPATOCELLUL AR CARCINOMA (HCC) < 20% of patients are suitable for liver-resection surgery and transplantation Have very poor prognosis TRANSARTERIAL CHEMOEMBOLIZA TION (TACE) Gold-standard palliative treatment of unresectable HCC (BCLC-B)
  3. A 81 y.o. man with unresectable HCC TACE was performed with a combination of Lipiodol and Doxorubicin, without any other treatment CT-scan imaging and liver function tests were performed before and after the TACE
  4. July, 2011 Multiple noduls Nodul: 6.7 x 5.7 x 5 cm ALT: 53.4 AST: 263.8 Total Bil.: 0.57 Alb: 3.95 March, 2016 Nodul: 4.3 x 4.5 x 6.7 cm June, 2016 Nodul: 4.6 x 4 x 5.6 cm Nov, 2016 ALT: 32.7 AST: 86.5 Total bil.: 0.26 Alb: 3.74 Jan, 2017 Nodul: 4.6 x 4.59 x 4.4 cm ALT: 10 AST: 39 Total bil.: 0.83 Alb: 3.96 1st TACE in Okt 2011 2nd TACE in April 2016 3rd TACE in Nov 2016 4th TACE in Jan 2017 AFP: 1636
  5. July 2011 March 2016 January 2017 June 2016 CT scan evaluation
  6. Indicate for large or multinodular HCC relatively preserved liver function absence of cancer- related symptoms no evidence of vascular invasion extrahepatic spread and no tumor thrombus in portal vein FIG. PROCEDURE OF TACE
  7. TACE  injection of an embolic agent into the tumor-feeding arteries to block its major nutrient source, and results in ischemic necrosis of the targeted tumor, with minimal adverse effect The dosage depends on the size of tumor. In this case, given doxorubicin 10mg as an embolant and lipiodol ultra fluid 10 cc, mix homogently and administrated via arterial chateterization to tumor gradually according to the blood pulse. PROCEDURE OF TACE
  8. Age factor, size of tumor and liver function test, surgery can not be applied to this patient. TACE was needed as a palliative treatment Tumor size decrease 52 %, and the liver function was improved The patient survive almost 6 years whereas in several RCTs, the most common survival rate post TACE (alone) treatment was 1 year.
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