Clinical application of transcatheter arterial chemoembolization combined with percutaneous radiofrequency in the treatment of large hepatic tumors
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Objective: To investigate the clinical role of transcatheter arterial chemoembolization ( TACE) combined with percutaneous radiofrequency ablation(RFA) in the treatment of large hepatic tumors. Methods: All of 42 patients with hepatocellular carcinomas were divided into three groupsCombination group consisted of14 patients ,received a combination therapy of TACE and RFA ;Fifteen patients were given the second TACE therapy only . And 13 patients with RFA therapy were the third group. The tumor necrosis rate and mean survival duration were observed. Results: Tumor necrosis rate was 78.6% in combination group , which was significantly higher than those in TACE group and RFA group (26.7%、46.2% ,P 0.05).Tumor local recurrence was 21.4%、46.7% and 38.5% in the combination group、 TACE group and RFA group . And there was no significant difference among the three groups(P0.05). Mean survival duration of combination group was 25.1 months, which was higher than that in TACE group (14.6 months)(P0.05).But it was similar to RFA group (19.9months)(P0.05). Conclusions: Compared with TACE or RFA therapy ,the combination therapy improved tumor necrosis rate and prolonged the patients′survival duration.Keywords:
Transcatheter arterial chemoembolization
Combination therapy
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Objectives: To investigate the efficacy and safety of RFA in treating primary hepatocellular carcinoma. Methods: Eighty-one patients with total 114 tumors were treated with radiofrequency ablation combined with TACE. Preoperative and postprocedural CT scans were taken in all patients. During follow-up patients underwent enhanced CT in every 2-3 month interval. Results: Median following-up duration was 30 ± 10.9months (17~49). The median survival time was 34 monthes (95%CI: 18-49 mo.).1-,2and 3-year survival rate was 96.6%,93.2% and 68.2%,respectively. 57 patients who were still alive when following-up ended. Conclusions: Radiofrequency ablation combined with TACE is effective and reliable in treating primary hepatocellular carcinoma. It may prolong the survival of the patients.
Transcatheter arterial chemoembolization
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Objective To investigate the efficacy and safety of radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) for treating of hepatic metastasis. Methods From Mar. 2005 to Oct. 2010, 22 males and 14 females with hepatic metastasis were enrolled in this study. Mean age of the patients was 63±12 (42-82) years. Tumor size was (4.5±2.4) cm (min.1.5 cm, max. 12.0 cm). Totally 47 lesions were treated with single metastasis in 29 cases and multiple ones in 7 cases. All cases were failed to chemotherapy or could not stand for the side effect of chemotherapy. Contrast enhanced CT scan was given to all patients before RFA+TACE. For lesions with rich blood supply, TACE was given and then RFA. For those with poor blood supply, RFA was given first and then TACE. For multiple lesions, RFA+TACE was given one by one for each lesion. As for follow up, ultrasound and blood check was given monthly. Enhanced CT scan was given every 3 month. For residual lesions or recurrent lesions, RFA+TACE were given repeatedly. The whole patients was divided into two groups according to the image follow up including complete ablation group and partial ablation group. For complete ablation group, no further treatment was given. For partial ablation group, if it was not suitable for further RFA, repeated TACE was given there after. The end point of follow up was death event. Survival of the whole group and the two subgroups was analyzed statistically by Kaplan-Meier method. Results All RFA procedures was given under intravenous anesthesia and local anesthesia, no severe complication was noted. Lesions in 16 patients were completely ablated after single or multiple sections of RFA+TACE. Twenty patients were in the partially ablated group. Follow up time was 25±10 (10-40) months. Twenty-three patients died and 13 kept alive during the follow up time. The estimated median survival time was 27 month (95%CI: 24-32 months). Survival ration at 1, 2, 3 years for the whole group was 91.7%(33/36),55.5%(20/36),36.1%(13/36) for the whole group. The 3 years survival for complete and partial ablation group was 75.0%(12/16),5.0%(1/20),there was a significant difference between the two groups(P<0.01). Conclusion For patients with hepatic metastasis, RFA+TACE can effectively control the local lesion. Complete ablation is the key point for a better survival.
Key words:
Liver neoplasms; Neoplasm metastasis; Catheter ablation; Embolization, therapeutic
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Objective:
To investigate the clinical value of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and 125I radioactive seed implantation for the treatment of liver cancer (≥10 cm) .
Methods:
Fifty-four patients with live cancer clinical or pathological verified of ≥10 cm in our hospital were selected, and all patients underwent TACE. Patients were randomly divided into radiofrequency ablation group (TACE+RFA, control group, n=28) and RFA plus 125I radioactivity seed implantation group (TACE+RFA+125I, combined group, n=26) . All patients were followed up for 1 to 37 months. The treatment efficiency and clinical control rate were compared between the two groups. Survival analysis was performed by Kaplan-Meier. Log-rank test was used to compare the survival curves.
Results:
The effective rate of the combined group was higher than that of the control group (61.5% vs. 32.1%) , with significant difference (χ2=4.685, P=0.030) . The median PFS in combined group and control group was 9 months and 5 months (P=0.010) , and the OS in combined group was longer than that in control group (11 months vs. 6 months, P=0.079) .
Conclusions:
The sequential therapy with TACE, RFA and radioactive particle has advantages in treating liver cancer with the diameter ≥10 cm. The PFS and tumor remission rate in combined group were more favorable than those in control group.
Key words:
Hepatocellular carcinoma; Radiofrequency ablation; Therapeutic effect; Radiology, 125I radioactivity seed implantation
Liver Cancer
Therapeutic effect
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Surgical oncology
Liver function
Liver Cancer
Transcatheter arterial chemoembolization
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Objective To evaluate the treatment efficacy and the necessity of radiofrequency ablation(RFA) followed by transarterial chemoembolization(TACE) for patients with unresectable primary liver cancer(PLC).Methods From April,2004 to January,2008,65 patients with unresectable PLCs underwent TACE after RFA.Fiftyfour cases were male,and 11 female.The maximum diameter of the tumor was 1.5 cm to 10 cm.Fourteen tumors were small(≤3 cm),17 were medium(3.1–5.0 cm) and 34 were large(5cm) or multi-nodular(≥3 nodules).The liver function(Child-Pugh) was class A in 51 cases,and class B in 14 cases.Fifty-eight cases were hepatocellular carcinoma and the other 14 cases were cholangiocarcinoma.RFA was performed by a RITA expandable electrodes device and followed by TACE using Seldinger′s technique.RFA response was evaluated with computed tomography performed one month after RFA,and then treatment efficacy was evaluated by observation of surviral.Results Classified by RFA response,patients received complete ablation in 24 cases,nearly ablation in 15 cases and partial ablation in 26 cases.The treatment efficacy of RFA plus TACE was curative in 22 cases,sub-curative in 13 cases and palliative in 26 cases.The relationships between RFA response and treatment efficacy were significantly correlated(r=0.877,P0.001).The total survival rate after RFA plus TACE at 1,2 and 3-year was 78.2%,65.3% and 44.0%,respectively.The 3-year survival rate for patients who received complete ablation,nearly ablation and partial ablation was 73.5%,45.0% and 0.0%,respectively.The smaller the tumor,the more complete was the tumor ablated,and the results were better.Conclusions TACE following RFA has therapentic effect and is nccessary for patients with medium or large PLC to eradicate residual tumor and micro-metastasis.
Liver Cancer
Liver function
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Objective
To investigate the effect of transcatheter arterial chemoembolization(TACE) combined with three dimensional conformal radiotherapy(3-DCRT) and hyperthermia on inoperable primary hepatic carcinoma.
Methods
This study retrospectively analyzed 96 patients with hepatic carcinoma in the Third Hospital of Chengde between 2014 and 2017 who received TACE or combined therapy (TACE combined with 3-DCRT and hyperthermia). Kaplan-Meier curve was used to compare the overall survival(OS) of the two groups.
Results
There were 50 cases in the combined therapy group, 46 cases in the TACE group.The effective rate of the combined therapy group was 76.1%, and that of TACE group was 45.6%, the difference was statistically significant(P=0.028). The overall 6-, 12- and 18-month survival rates of the combined therapy group were 98.0%, 89.9% and 63.1%, respectively, which in the TACE group were 91.3%, 67.3% and 46.8%, respectively, the difference between the two groups was significant(χ2=7.836, P=0.005). The incidence of adverse effect of the combined therapy group was low, only 2 patients(4.0%) developed radiation-induced liver disease(RILD), and the liver function recovered to the normal level after 8 weeks.
Conclusion
TACE combined with 3-DCRT and hyperthermia is more effective than TACE alone for inoperable primary hepatic carcinoma, and with a low incidence of adverse effect.
Key words:
Liver neoplasms; Transcatheter arterial chemoembolization; Radiotherapy; Hyperthermia
Transcatheter arterial chemoembolization
Liver function
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Surgical oncology
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Citations (138)
Objective To investigate the clinical effect of a combination therapy of 3 Dimension conformal technology guided radiofrequency ablation(RFA)and transcatheter arterial chemoembolization(TACE) in primary hepatic carcinoma.Methods Among 56 patients with hepatic carcinoma,20 patients received a combination therapy of TACE and RFA(combination group),22 patients TACE alone,and the rest 16 patients RFA alone.Moreover,there was no significant difference in mean age,tumor size and liver function grade among the three groups.Results The complete necrosis rate of tumor accounted for 80.0% in combination group,which was significantly higher than that of TACE group and RFA group(30.0% and 43.8%,respectively,P0.05).The local recurrence rate of tumor in the combmation group,TACE group and RFA group was 30.0%,43.8%,and 30.0%,respectively,there was no significant difference among the three groups(P 0.05).Mean survival duration of combination group was 20.0 months,which was higher than that of TACE group(19.8 months),and that of RFA group(17.6 months),but there was no significant difference among the three groups(all P 0.05).Conclusion Under the utilization of 3D-TPS,radiofrequency ablation was more safe and precise.Compared with TACE or RFA therapy alone,a combination therapy of transcatheter arterial chemoembolization and radiofrequency ablation could improve tumor complete necrosis rate and extend the patients' survival duration.
Transcatheter arterial chemoembolization
Combination therapy
Hepatic carcinoma
Liver function
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Objective To investigate the effectiveness and safety of TACE in combination with percutaneous microwave coagulation therapy(PMCT) in treatment of large hepatocellular carcinoma(5—10 cm).Methods Totally 102 patients of large hepatocellular carcinoma were randomly divided into 2 groups.A total of 42 patients were enrolled in TACE group,and 60 patients were enrolled in the synthetic therapy group(TACE+PMCT group).Both groups were given conventional TACE for once or several times.After TACE,PMCT was performed in TACE+PMCT group within 1—2 weeks.Then follow-up was done,and the therapeutic effect and complication in both groups were evaluated.Results The partial response rate,complete response rate and the descent rate of AFP for the TACE+PMCT group were higher than those of the TACE group,respectively(P=0.030,0.024,0.020).The 1-and 2-year survival rate in TACE+PMCT group were also higher than those in TACE group(P=0.007,0.001),with the median survival time was 19 months and 13 months in TACE+PMCT group and TACE group,respectively(P=0.007,0.001).No severe complications occurred.Conclusion TACE combined with PMCT can significantly increase survival rate and survival period in patients with hepatocellular carcinoma.
Microwave ablation
Therapeutic effect
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Objective To investigate the therapeutic effect of transcatheter arterial chemo-embolization (TACE) combined with CT-guided percutaneous radiofrequency ablation (RFA) in treating advanced primary hepatocellular carcinoma. Methods Eighty-five cases with advanced primary hepatocellular carcinoma were randomly divided into group A and group B. In group A, 43 cases were treated with TACE, and in group B, 42 cases were treated with TACE and RFA. Results The complete necrosis rate of tumor, the recurrence rate, and one-year survival rate were 20 93%, 39.53%, and 79 07%, respectively in group A, and 92.86%?9.53%, and 97.62%, respectively in group B. There were significant statistical differences between the two groups (P value were 0.001, 0.004, and 0 009, respectively). Conclusion The therapeutic effects of TACE combined with CT-guided RFA show better results than that of TACE alone.
Transcatheter arterial chemoembolization
Therapeutic effect
Group B
Arterial Embolization
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