General criteria of surgical resection were (1) patients with tumor involving no more than 3 Healey’s segment, (2) Child-Turcotte-Pugh (CTP) class A, and (3) no main portal vein trunk involvement or distant metastasis. Liver transplantation was considered in patients fulfilling the Milan criteria [15 (link)]. TACE was performed depending on the size and number of tumor nodules as previously reported [5 (link), 7 (link)]. Seldinger’s technique of arterial embolization was performed as the standard TACE procedure. After tumor stain was identified, infusion of a mixture of 20–30 mg adriamycin (Carlo Erba, Milan, Italy) and 5–10 mL Lipiodol (Laboratoire Guerbet, Villepinte, France) was performed after the artery supplying the tumor was catheterized superselectively. Sufficient amount of emulsion and 2–3 mm strips of Gelfoam (Upjohn, Kalamazoo, MI) were delivered to the tumor area until complete flow stagnation was achieved.
Adriamycin
Manufactured by Carlo Erba
Sourced in Italy
Adriamycin is a laboratory equipment product manufactured by Carlo Erba. It is used for analytical and research purposes in various scientific settings.
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Lab products found in correlation
4 protocols using adriamycin
1
Surgical Resection and TACE for Hepatocellular Carcinoma
2
Transarterial Chemoembolization for Hepatocellular Carcinoma
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Conventional TACE was performed by a treatment-on-demand schedule.13 (link) Therefore, a TACE session would not be performed in the case of a complete radiologic response. To preserve as much viable liver parenchyma as possible, the feeding arteries of the tumor were catheterized superselectively. A mixture of 20� mg to 30� mg adriamycin (Carlo Erba, Milan, Italy) and 5� mL to 10� mL Lipiodol (Laboratoire Guerbet, Roissy-Charles-de-Gaulle Cedex, France) was infused into the supplying arteries. The dose of adriamycin and Lipiodol was decided depending on the size, number, and vascularity of the tumors. Under fluoroscopic guidance, the vessels were subsequently embolized with Gelfoam (Upjohn; Kalamazoo, MI) of less than 1-mm strips until complete flow stagnation was achieved. Laboratory measurements of serum biochemistry, AFP levels, and dynamic imaging studies of the liver were performed every 2 to 3 months after TACE. TACE was repeatedly performed in patients with compensated liver disease and residual viable tumor on dynamic imaging studies. The best supportive care was given if advanced liver failure occurred. Single-agent sorafenib was considered for patients with advanced HCC, including main and first branch of portal vein invasion and/or extrahepatic spread and preserved liver function (Child–Pugh class A).
3
Superselective TACE for Liver Tumors
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At first, tumor stains and tumor feeding artery were identified, then catheterization was superselectively advanced into the branches of tumor feeding artery with a 1.98-/2.5-Fr microcatheter through a 4-/5-Fr catheter (Terumo, Tokyo, Japan or Cook Medical, Bloomington, IN, USA). The subsegmental TACE was performed with a mixture of 20–30 mg adriamycin (Carlo Erba, Milan, Italy) and 5–10 mL of lipiodol (Laboratoire Guerbet, Paris, France), followed by the delivery of 2–3 mm2 strips of Gelfoam (Upjohn Co., Kalamazoo, MI, USA). Based on the tumor size and baseline liver function, interventional radiologist determined the total amount of iodized oil individually. During procedure, all target tumors were assessed by decreased antegrade tumor-feeding arterial flow. The embolization endpoint was reduced or no tumor stain along with subjective angiographic chemoembolization endpoint levels 2 and 3 [33 (link)].
4
Selective Radioembolization and TACE for HCC
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The selection criteria for SR required tumor nodule (1) confined to single lobe, or tumors involving no more than 3 Healy’s segment, (3) no main portal vein thrombosis or distant metastasis, (4) CTP class A or B, with < 20% retention rate of indocyanine green at 15 min after injection. The inclusion criteria for TACE were (1) patients who were unsuitable or refused surgery, (2) no main portal vein thrombosis or distant metastasis, and (3) CTP class A or B. The Seldinger’s technique of arterial embolization was administered as the standard TACE procedure described in previous studies9 (link),10 (link),18 (link). After tumor stain was identified, infusion of a mixture of 20–30 mg adriamycin (Carlo Erba, Milan, Italy) and 5–10 mL lipiodol (Laboratoire Guerbet, Villepinte, France) was performed after the artery supplying the tumor was catheterized superselectively. Sufficient amount of emulsion and 2- to 3-mm strips of Gelfoam (Upjohn, Kalamazoo, MI, USA) were delivered to the tumor area until complete flow stagnation was achieved. After SR or TACE, post-treatment follow-up imaging including liver sonography, dynamic CT or MRI, and serum AFP level, were performed every 3–4 months or more frequently if necessary.
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