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Written by: Hou Cailin
2020-01-20 00:00
Last updated: 2020-01-20 00:00There are about 1,800 new liver cancer cases in Hong Kong every year. Currently, surgical resection and liver transplantation are the only effective methods to cure liver cancer. Only 70% of patients are not suitable for surgical resection and liver transplantation. They can only be treated with interventional therapy and drugs. Only one in ten patients with tumors can be completely eliminated.
The University of Hong Kong Medical School and the Queen Mary Hospital conducted a study in which stereotactic radiation therapy and immunotherapy were combined to reduce the tumor volume first in order to reduce the size of the tumor in a “shrink first and then remove” approach to increase the chance of surgery to cure liver cancer. At present, only the Queen Mary Hospital in Hong Kong adopts this therapy and charges it at the standard of public hospitals. The team expects that the project will complete research in about 3 years and expand the treatment plan to hospitals in Hong Kong in the future.
The University of Hong Kong and Mary's Hospital develops a "retract first and then remove" therapy to help cure advanced liver cancer. (Photo by Hou Cailin)
70% of liver cancer patients are not suitable for surgery
Chen Zhiren, associate clinical professor of surgery at the University of Hong Kong and Honorary Consultant Doctor at the Queen Mary Hospital, said that primary liver cancer ranks fifth among common cancers in Hong Kong. Only 70% of patients are of advanced or poor liver function and are not suitable for surgical resection of tumors or liver transplantation. Underwent arterial chemoembolization, only one in ten patients had tumors completely eliminated.
HKU Medical College and Queen Mary Hospital have been researching a new treatment strategy since 2018. Combining stereotactic radiation therapy and immunotherapy, five-day stereotactic radiation therapy is used to reduce tumors, and two to three weeks later, about four months. Immunotherapy followed by surgery to remove the tumor. The new treatment strategy is expected to help patients with liver cancer who have not undergone surgical resection or liver transplantation.
Chen Zhiren (left), associate professor of clinical surgery at the University of Hong Kong (left) and Jiang Ziliang (right), assistant professor of clinical oncology at the University of Hong Kong, introduced the new treatment plan with patient Guo.
Treatment must meet at least three conditions
Jiang Ziliang, assistant professor of clinical oncology at the University of Hong Kong and honorary deputy consultant doctor at Queen Mary Hospital, pointed out that in the past, stereotactic radiotherapy alone had been difficult to eliminate tumors over 10 centimeters, and new therapies can help shrink tumors and avoid tumor spread. To receive this treatment technique, there are also a number of conditions that must be met, including a tumor volume of no less than 8 cm and a tumor number of less than four. The tumor does not invade the main blood vessels, and at least three conditions must be met.
The research team published the world's first initial report on the course of treatment earlier this year. The report mentioned that five patients had received the treatment technique, three of which had been completely cured, and the remaining two patients had tumors shrank by at least 30%. The condition was good, and all patients showed no signs of spread and recurrence. At present, only the Queen Mary Hospital in Hong Kong adopts this new treatment and charges public hospitals. The research team expects to publish a more complete research report in about three years and to promote the therapy to hospitals in Hong Kong in the future.
Mr. Guo (middle) described the new therapy as giving him "new hope in despair." (Photo by Hou Cailin)
Healing patients: new hope in despair
Mr. Guo, 55, is one of the liver cancer patients receiving this treatment. During a checkup in June 2018, he found a tumor measuring 9 cm in the center of the liver. Mr. Guo described that when he learned that he had liver cancer, "the whole family seemed to be desperate." However, because Mr. Guo's liver was large, it was not appropriate to perform surgical resection of the tumor, so he chose a new treatment. After treatment, Mr. Guo's tumor shrank to 1.4 cm, and he performed radiofrequency ablation in March last year to eliminate the residual tumor. Mr. Guo returned to work three months after the operation, and he described the new therapy as giving him "new hope in despair."
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