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master's thesis
Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma
Zagreb: University of Zagreb, School of Medicine, 2024. urn:nbn:hr:105:128951
Brajković, Tomislav
University of Zagreb
School of Medicine
Department of Radiology

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

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Brajković, T. (2024). Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:128951

Brajković, Tomislav. "Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma." Master's thesis, University of Zagreb, School of Medicine, 2024. https://urn.nsk.hr/urn:nbn:hr:105:128951

Brajković, Tomislav. "Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma." Master's thesis, University of Zagreb, School of Medicine, 2024. https://urn.nsk.hr/urn:nbn:hr:105:128951

Brajković, T. (2024). 'Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma', Master's thesis, University of Zagreb, School of Medicine, accessed 26 November 2024, https://urn.nsk.hr/urn:nbn:hr:105:128951

Brajković T. Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2024 [cited 2024 November 26] Available at: https://urn.nsk.hr/urn:nbn:hr:105:128951

T. Brajković, "Kriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2024. Available at: https://urn.nsk.hr/urn:nbn:hr:105:128951

Metadata
TitleKriterij i mogućnosti endovaskularnog liječenja hepatocelularnog karcinoma
Title (english)Criteria and possibilities of endovascular treatment of hepatocellular carcinoma
AuthorTomislav Brajković
MentorVinko Vidjak (mentor)
Committee memberTajana Filipec Kanižaj (predsjednik povjerenstva)
Committee memberGordana Ivanac (član povjerenstva)
Committee memberVinko Vidjak (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Radiology)
Zagreb
Defense date and country2024-07-12, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Radiology
Abstract
Hepatocelularni karcinom predstavlja najčešći primarni maligni tumor jetre, čija incidencija raste u cijelome svijetu. Endovaskularno liječenje obuhvaća različite metode ciljane terapije putem krvnih žila koje opskrbljuju tumorsko tkivo. Glavne metode endovaskularnog liječenja su: konvencionalna transarterijska kemoembolizacija (cTACE), transarterijska radioembolizacija (TARE), transarterijska embolizacija pomoću čestica koje otpuštaju lijek (DEB-TACE), balon okluzivna embolizacija (B-TACE) te BLAND embolizacija. cTACE je metoda koja kombinira dostavu kemoterapijskih lijekova direktno u žilu koja opskrbljuje tumor i ciljanu embolizaciju. TARE metoda uključuje endovaskularnu dostavu radioaktivnih čestica, najčešće itrij-90, u arteriju koja opsrkrbljuje tumor s ciljem njegove nekroze. U DEB TACE kombiniraju se mikrosfere koje kontinuirano otpuštaju lijek sa embolizacijom krvnih žila tumora, a cilj je osigurati opstrukciju tumorskih krvnih žila te omogućiti kontinuirano otpuštanje kemoterapijskog agensa u tumorsku tkivo, uz minimalnu sistemsku izloženost kemoterapeutiku. Kod B-TACE upotrebom balonskog mikrokatetera neposredno prije izvođenja kemoembolizacije smanjuje se lokalni krvni tlak i povećava izloženost citostatiku. BLAND embolizacija podrazumijeva ciljanu embolizaciju krvnih žila koje hrane tumor bez upotrebe kemoterapijskih lijekova. Pravilan izbor pacijenata koji su kandidati za endovaskularno liječenje je ključan za optimalne rezultate i zasniva se na nekoliko kriterija. Pacijenti sa ranim do srednje uznapredovalim stadijem HCC-a (Barcelona Clinic Liver Cancer (BCLC) stadij A i B) , očuvane funkcije jetre i očuvanih životnih sposobnosti, bez vaskularne invazije i bez ekstrahepatalne proširenosti tumora su najčešći kandidati za endovaskularno liječenje. Endovaskularno liječenje omogućuje sniženje stadija tumora do razine ispunjavanja kriterija koji otvaraju mogućnost transplantacije jetre. Kao metoda premoštenja endovaskularne metode koriste kod pacijenata koji se već nalaze unutar kriterija za transplantaciju jetre, s ciljem sprječavanja progresije tumora tijekom boravka na listi čekanja.
Abstract (english)
Hepatocellular carcinoma is the most common primary malignant liver tumor, with an increasing incidence worldwide. Endovascular treatment includes various methods of targeted therapy through the blood vessels supplying the tumor tissue. The main methods of endovascular treatment include conventional transarterial chemoembolization (cTACE), transarterial radioembolization (TARE), drug eluting beads transarterial embolization (DEB- TACE), balloon-occluded transarterial chemoembolization (B-TACE) and BLAND embolization. cTACE is a method that uses a combination of delivering chemotherapeutic drugs directly into the vessel feeding the tumor and embolization. TARE involves endovascular delivery of radioactive particles (most commonly yttrium-90 ) into the artery supplying the tumor, with the aim of inducing necrosis. DEB-TACE combines microspheres that continuously release the drug with embolization of the tumor blood vessels, aiming to ensure obstruction of the tumor blood vessels and continuous release of the chemotherapeutic agent into the tumor tissue. In B-TACE, the use of a balloon microcatheter immediately before performing chemoembolization reduces local blood pressure and increases the exposure to the cytostatic agent. BLAND embolization involes targeted embolisation of the blood vessels feeding the tumor without using chemotherapeutic agents. The proper selection of patients who are candidate for endovascular treatment is crucial and is based on several criteria. Patients with early to intermediate stage hepatocellular carcinoma (Barcelona Clinic Liver Cancer (BCLC) stages A and B), preserved liver function, good performance status, without vascular invasion and without extrahepatic spread of the tumor, are the most common candidates for endovascular treatment. Endovascular treatment allows for the downstaging of the tumor to a level that meets criteria for liver transplantation. Endovascular treatment is also used as a bridging therapy for patients already within criteria for liver transplantation, aiming to prevent tumor progression while on waiting list.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:128951
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2024-07-08 12:03:15