Effect of Nigella Sativa Oil on the Treatment of Hypertension
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Background: Transarterial chemoembolization (TACE) is an established locoregional therapy for selected patients with hepatocellular carcinoma (HCC). Post-treatment contrast-enhanced imaging is important because viable HCC is assessed by residual arterial enhancement rather than lesion size alone. Objective: To evaluate radiological response following TACE using triphasic CT and modified Response Evaluation Criteria in Solid Tumors (mRECIST). Methods: This retrospective observational study included 50 patients with HCC who underwent TACE at CMA Hospital, Lahore, from February to July 2025. Pre- and post-treatment triphasic CT studies were reviewed for lesion size and treatment response. Paired lesion size was evaluated using the Wilcoxon signed-rank test, and response was categorized using mRECIST. Results: Mean lesion size decreased from 5.33±1.39 to 2.77±2.02 cm, an absolute difference of 2.56 cm and a 48.0% relative reduction in the group means (Wilcoxon Z=−5.266, p<0.001; r≈0.74). Complete response occurred in 33/50 patients (66.0%; 95% CI 52.2–77.6%), stable disease in 12/50 (24.0%), and progressive disease in 5/50 (10.0%); no partial responses were reported. The resulting objective response rate was 66.0% and disease-control rate was 90.0% (95% CI 78.6–95.7%). Conclusion: The cohort demonstrated substantial post-TACE radiological response on triphasic CT. Interpretation is limited by the retrospective single-center design and incomplete characterization of TACE technique, liver-function status, tumor stage, and follow-up interval.
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1. Llovet JM, Kelley RK, Villanueva A, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2021;7(1):6. doi:10.1038/s41572-020-00240-3.
2. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma. J Hepatol. 2025;82(2):315-374. doi:10.1016/j.jhep.2024.08.028.
3. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. J Hepatol. 2022;76(3):681-693. doi:10.1016/j.jhep.2021.11.018.
4. Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466.
5. Zhong BY, Jin ZC, Chen JJ, et al. Role of transarterial chemoembolization in the treatment of hepatocellular carcinoma. J Clin Transl Hepatol. 2023;11(2):480-489. doi:10.14218/JCTH.2022.00293.
6. Chang Y, Jeong SW, Jang JY, Kim YJ. Recent updates of transarterial chemoembolilzation in hepatocellular carcinoma. Int J Mol Sci. 2020;21(21):8165. doi:10.3390/ijms21218165.
7. Lammer J, Malagari K, Vogl T, et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol. 2010;33(1):41-52. doi:10.1007/s00270-009-9711-7.
8. Chen J, Huang G, Mo F, Liao Z, Zhao C. Comparative efficacy and safety of transarterial treatment strategies for hepatocellular carcinoma: a systematic review and network meta-analysis of randomized controlled trials. Front Med (Lausanne). 2026;13:1881070. doi:10.3389/fmed.2026.1881070.
9. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52-60. doi:10.1055/s-0030-1247132.
10. Prajapati HJ, Spivey JR, Hanish SI, et al. mRECIST and EASL responses at early time point by contrast-enhanced dynamic MRI predict survival in patients with unresectable hepatocellular carcinoma treated by doxorubicin drug-eluting beads transarterial chemoembolization. Ann Oncol. 2013;24(4):965-973. doi:10.1093/annonc/mds605.
11. Vincenzi B, Di Maio M, Silletta M, et al. Prognostic relevance of objective response according to EASL criteria and mRECIST criteria in hepatocellular carcinoma patients treated with loco-regional therapies: a literature-based meta-analysis. PLoS One. 2015;10(7). doi:10.1371/journal.pone.0133488.
12. Dioguardi Burgio M, Sartoris R, Libotean C, et al. Lipiodol retention pattern after TACE for HCC is a predictor for local progression in lesions with complete response. Cancer Imaging. 2019;19(1):75. doi:10.1186/s40644-019-0260-2.
13. Letzen BS, Malpani R, Miszczuk M, et al. Lipiodol as an intra-procedural imaging biomarker for liver tumor response to transarterial chemoembolization: post-hoc analysis of a prospective clinical trial. Clin Imaging. 2021;78:194-200. doi:10.1016/j.clinimag.2021.05.007.
14. Park C, Gwon DI, Chu HH, et al. Correlation of tumor response on CT with pathologically proven necrosis in hepatocellular carcinoma treated by conventional transcatheter arterial chemoembolization: threshold value of intratumoral Lipiodol accumulation predicting tumor necrosis. Abdom Radiol (NY). 2021;46(8):3729-3737. doi:10.1007/s00261-020-02845-4.
15. Wang H, Han Y, Chen G, Jin L. Imaging biomarkers on Angio-CT for predicting the efficacy of transarterial chemoembolization in hepatocellular carcinoma. Quant Imaging Med Surg. 2023;13(7):4077-4088. doi:10.21037/qims-22-1355.
16. Naves GG, Dantas PP, Silva Júnior AED, et al. CT and MRI LI-RADS Treatment Response Assessment 2024: core concepts for clinical practice. Radiographics. 2026;46(4). doi:10.1148/rg.250067.
17. Kadalayil L, Benini R, Pallan L, et al. A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer. Ann Oncol. 2013;24(10):2565-2570. doi:10.1093/annonc/mdt247.
18. Jiang JQ, Huang JT, Zhong BY, et al. Transarterial chemoembolization for patients with unresectable hepatocellular carcinoma with Child-Pugh B7. J Hepatocell Carcinoma. 2023;10:1629-1638. doi:10.2147/JHC.S422300.
19. Prasitsumrit V, Thiravetyan B, Sodsri T, et al. Risk factors for hepatic failure after transarterial chemoembolization in patients with hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2026;38(8):893-901. doi:10.1097/MEG.0000000000003137.
20. Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141(1):2-18. doi:10.1037/a0024338.
21. Werida RH, Abd El Baset OA, Askar S, et al. Efficacy of doxorubicin and Lipiodol therapy by trans-arterial chemoembolization in hepatocellular carcinoma Egyptian patients and relation to genetic polymorphisms. Expert Rev Anticancer Ther. 2024;24(10):1009-1020. doi:10.1080/14737140.2024.2391364.
22. Yamada R, Bassaco B, Bracewell S, et al. Combined conventional transarterial chemoembolization with Mitomycin and percutaneous ablation for unresectable hepatocellular carcinoma. J Gastrointest Oncol. 2020;11(2):298-303. doi:10.21037/jgo.2019.01.07.