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Traitement d’un carcinome hépatocellulaire avancé associé à une thrombose porte par radioembolisation au microsphères d’Yttrium-90

Treatment of an advanced hepatocellular carcinoma associated with a portal thrombosis by radioembolization with microspheres of Yttrium-90

  • Article Original / Original Article
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Journal Africain du Cancer / African Journal of Cancer

Résumé

Le carcinome hépatocellulaire (CHC) est le cancer primitif du foie le plus fréquent. La transplantation hépatique, la résection chirurgicale ou les traitements de destruction locale sont les seuls traitements curatifs. Seulement 15 à 25 % des patients sont candidats à un traitement curatif d’emblée. La majorité des patients ont un CHC non résécable. Le traitement palliatif de ces patients reste difficile malgré plusieurs procédés thérapeutiques disponibles, et la présence d’une thrombose porte limite encore plus les choix thérapeutiques. La radioembolisation par l’Yttrium-90 (Y-90) semble avoir une bonne efficacité et une bonne tolérance et la présence d’une thrombose portale ne contre-indique pas sa réalisation. Elle peut être utilisée comme un traitement « bridge » à une transplantation hépatique. Nous rapportons le cas d’un patient ayant un CHC localement avancé, associé à une thrombose portal, dont le traitement par radioembolisation à l’Yttrium-90 a permis une régression de la thrombose portale et une survie prolongée.

Abstract

Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver. Hepatic transplantation, surgical resection or local destruction are the only curatives options. Only 15% to 25% of patients are candidate to a curative treatment and most of them have unresectable HCC. Palliative treatment of these patients remains difficult in spite of several available therapeutic options. The presence of portal thrombosis, limits even more the therapeutic choices. The Yttrium-90 (Y-90) radioembolization seems to have good efficacy and safety even in case of portal thrombosis, and it can be used as a “bridge” treatment before a hepatic transplantation. We report the case of a patient having a locally advanced HCC, associated with a thrombosis portal, the treatment by radioembolization with Yttrium-90 allowed a regression of the portal thrombosis and a prolonged survival.

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Authors and Affiliations

  1. Hopital Tenon, APHP, Paris, France

    A. El Mekkaoui, I. Grigoriu & J. -D. Grangé

  2. Institut Gustave Roussy, Villejuif, France

    Z. Benbrahim

  3. Hopital Jean Verdier, APHP, Bondy, France

    I. Charif

Authors
  1. A. El Mekkaoui
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  2. Z. Benbrahim
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  3. I. Charif
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  4. I. Grigoriu
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  5. J. -D. Grangé
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Correspondence to A. El Mekkaoui.

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El Mekkaoui, A., Benbrahim, Z., Charif, I. et al. Traitement d’un carcinome hépatocellulaire avancé associé à une thrombose porte par radioembolisation au microsphères d’Yttrium-90. J Afr Cancer 4, 37–40 (2012). https://doi.org/10.1007/s12558-012-0203-8

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  • DOI: https://doi.org/10.1007/s12558-012-0203-8

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