DOI QR코드

DOI QR Code

Efficacy of Transarterial Chemoembolization Combined with Radiofrequency Ablation in Treatment of Hepatocellular Carcinoma

  • Xu, Chuan (Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University) ;
  • Lv, Peng-Hua (Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University) ;
  • Huang, Xin-En (Department of Chemotherapy, Jiangsu Cancer Hospital, Nanjing Medical University) ;
  • Wang, Shu-Xiang (Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University) ;
  • Sun, Ling (Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University) ;
  • Wang, Fu-An (Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University)
  • Published : 2015.09.02

Abstract

Purpose: To evaluate efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of patients with hepatocellular carcinoma. Materials and Methods: During January 2009 to March 2012, 80 patients with hepatocellular carcinoma underwent TACE, with or without RFA. Alfafetoprotein (AFP) was checked before and after procedure. CT scans were obtained one month after TACE or RFA for all patients to evaluate tumor changes. Complete response+partial response+stable disease (CR+PR+SD)/n were used to assess the disease control rate (DCR). Survival at 3, 6 and 12 months was compared in both groups. Results: AFP levels in TACE + RFA group dropped rapidly, becoming obviously lower than that of the TACE group. In the TACE + RFA group DCR was 93.8%, while only 76.8% in the TACE group. The treatment effect between the two groups was statistically significant (P<0.05) by Ridit analysis. 1 year survival rate in the TACE + RFA group was 92.5%, significantly higher than that of the TACE group at 77.5% (P<0.05). Conclusions: TACE and RFA as combined therapy method for patients with middle and terminal stage HCC gives full play to synergy between the two and improves the therapeutic effect.

References

  1. Benson AB, Abrams TA, Ben JE, et al (2009). NCCN clinical practice guidelings in omcology: hepatobiliary cancers. J Natl Compr Canc Netw, 7, 350-59.
  2. Bruix J, Sherman M, Llovet JM, et al (2001). Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. European Association for the study of the Liver. J Hepatol, 35, 421-30. https://doi.org/10.1016/S0168-8278(01)00130-1
  3. Burrel M, Reig M, Forner A, et al (2012). Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolization (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design. J Hepatol, 56, 1330-35. https://doi.org/10.1016/j.jhep.2012.01.008
  4. Chinn SB, Lee FT, Kennedy, et al (2001). Effect of vascular occlusion on radfiofrequency ablation of the liver: Results in a porcine model. AJR Am J Roentgenol, 176, 789-95. https://doi.org/10.2214/ajr.176.3.1760789
  5. Cho YK, Kim JK, Kim WT, at al (2010). Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: a Markov model analysis. Hepatol, 51, 1284-90. https://doi.org/10.1002/hep.23466
  6. Germani G, Pleguezuelo M, Gurusamy, et al (2010). Clinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocellular: a meta-analysis. J Hepatol, 52, 380-87. https://doi.org/10.1016/j.jhep.2009.12.004
  7. Golfieri R, Renzulli M, Mosconi C et al (2013). Hepatocellular carcinoma responding to superselective transarterial chemoembolization: an issue of nodule dimension? J Vasc Interv Radiol, 24, 509-17. https://doi.org/10.1016/j.jvir.2012.12.013
  8. Hsu CY, Huang YH, Chiou YY, et al (2011). Comparision of radiofrequency ablation and transterial chemoembolization for hepatocellular carcinoma within the Milan criterial: a propensity score analysis. Liver Transpl, 17, 556-66. https://doi.org/10.1002/lt.22273
  9. Liapi E, Geschwind JF (2011). Transcatheter arterial chemoembolization for liver cancer: is it time to distinguish conventional from drugeluting chemoembolization? Cardiovasc Intervent Radiol, 34, 37-49. https://doi.org/10.1007/s00270-010-0012-y
  10. Llovet JM, Bru C, Bruix J (1999). Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis, 19, 329-38. https://doi.org/10.1055/s-2007-1007122
  11. Riaz A, Lewandowski RJ, Kulik L, et al (2010). Radiologicpathologic correlation of hepatocellular carcinoma treated with chemoembolization. Cardiovasc Intervent Radiol, 33, 1143-52. https://doi.org/10.1007/s00270-009-9766-5
  12. Reig M, Rimola J, Torres F et al (2013). Postprogression survival of patients with advanced hepatocellular carcinoma: rational for second-line trial design. Hepatol, 2023-31
  13. Wilson TR, Fridlyand J, Yan Y, et al (2012). Widespread potential for growth-factor-driven resistence to anticancer kinase inhibitors. Nature, 487, 505-9. https://doi.org/10.1038/nature11249
  14. Yang JD, Kim WR, Park KW, et al (2012). Model to estimate survival in ambulatory patients with hepatocellular carcinoma. Hepatol, 56, 614-21. https://doi.org/10.1002/hep.25680
  15. Yau T, Tang VY, Yao TJ, at al (2014). Development of Hong Kong liver cancer staging system with treatment stratification for patients with hepatocellular carcinoma. Gastroenterol, 146, 1691-170. https://doi.org/10.1053/j.gastro.2014.02.032

Cited by

  1. 3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7897
  2. Safety and Efficacy of a Mouth-Rinse with Granulocyte Colony Stimulating Factor in Patients with Chemotherapy-Induced Oral Mucositis vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.413
  3. A Clinical Study on Juheli (Recombinant Human Interleukin - 11) in the Second Prevention of Chemotherapy Induced Thrombocytopenia vol.17, pp.2, 2016, https://doi.org/10.7314/APJCP.2016.17.2.485
  4. Hepatocellular carcinoma: Where are we? vol.6, pp.1, 2016, https://doi.org/10.5493/wjem.v6.i1.21