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Liver Cancer, 1595498510, rfa, mfa, ooo, Dtbezn3nNUxytg04N0wJ1YS3d6uPUN…
Liver Cancer
การรักษา HCC/CCA
Surgery
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CCA stage1,2 Hepatectomy,Radical resection,Regional lymphadenectomy
CMT
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First line,Advance/Metastasis HCC/CCA
Cis/5FU q 28 Day 6 cycle → S/E : N/V,Nephrotoxicity,Auditory impairment
Gem/Cis q 14 Day 6 cycle → S/E:Neutropenia,Anemia,Auditory impairment
Carbo/5FU q 28 Day 6 cycle →S/E:Thombocytopenia,Neurotoxicity
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Targeted therapy
HCC 1ST Sorafenib → S/E: N/V,mucositis,Fatigue
HCC 2nd Legorafenib → S/E: Hand-foot Syndrom,Diarrhea,Hypertention
HCC 2nd Bevacizumab → S/E: Hypertention, Fatigue,hemorrhage
Immunotherapy
HCC Atezolizumab →S/E: Thombocytopenia,UTI
HCC Nivolumab →S/E: Rash,Fatigue
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Palliative Care HCC/CCA
Symptoms : Pain,Ascitis,Dypnea,Cachexia
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การวินิจฉัย HCC/CCA
ซักประวัติตรวจร่างกาย Clinical:Jaundice,คลำพบก้อนชายโครงขวา,อืดแน่นท้อง
LAB (HCC) : AFP↑ , (CCA) : ALP,ALT,AST,CEA,CA19-9 ↑
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Liver Bx. Patho → HCC :Hepatocellular Carcinoma 90 %, CCA:Adenocarcinoma 90 %
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CCA:Chloangiocarcinoma
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สาเหตุ
Biliary Tract stone,พยาธิใบไม้ในตับ,อาหารสุกๆดิบๆ
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