Dexamethasone and N-acetylcysteine before transarterial chemoembolization in hepatocellular carcinoma:A Western perspective  

作　　者：Marco Biolato Maurizio Pompili 

机构地区：[1]Department of Medical and Surgical Sciences,CEMAD Digestive Disease Center,Fondazione Policlinico Universitario Agostino Gemelli IRCCS,Rome 00168,Italy [2]Department of Translational Medicine and Surgery,Catholic University of Sacred Heart,Rome 00168,Lazio,Italy

出　　处：《World Journal of Gastroenterology》2024年第31期3635-3639,共5页世界胃肠病学杂志（英文版）

摘　　要：Post-embolization syndrome(PES)is the most common complication in patients with hepatocellular carcinoma treated with transarterial chemoembolization.Many strategies have been evaluated to reduce the incidence of PES,but no standard prevention guidelines currently exist.In a single-center,placebo-controlled trial,Simasingha et al evaluated the prophylactic administration of a combination of dexamethasone and N-acetylcysteine and documented a significant reduction in the incidence of PES(from 80%to 6%),of post-procedural liver decompensation(from 14%to 0%),and a shorter hospital stay(4 days vs 6 days),alongside an acceptable safety profile.The results of this study raise several controversial points regarding their applicability in the Western world.In the West,there is a greater and increasing prevalence of metabolic and alcoholic etiologies of liver cirrhosis,so a not negligible number of patients with type II diabetes or hypertension would be excluded from high-dosage dexamethasone prophylaxis.Furthermore,in the West,there is a preferred use of drug-eluting beads loaded with doxorubicin,which are associated with a lower incidence of PES.A study on prophylaxis with dexamethasone and/or N-acetylcysteine in a Western population is hopefully awaited.

关 键 词：Chemotherapeutic drugs LIPIODOL Post-embolization syndrome Prevention PROPHYLAXIS 

分 类 号：R735.7[医药卫生—肿瘤]