Abstract
This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P < 0. 05). During 2 to 28 months of follow- up, in 19 cases with complete response, the average time without disease recurrence was 10.8 ± 6 months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.
Highlights
Transcatheter arterial chemoembolization (TACE) combined with synchronous C-arm cone-beam CT guided radiofrenquency ablation (RFA) were performed on a total of 25 lesions
Hepatocellular carcinoma (HCC) is the sixth major malignant tumor in the world and the third tumor leading to deaths
Application of TACE combined with C-arm CT guided synchronous RFA to treatment of unresectable large HCC or huge HCC has not been reported
Summary
Hepatocellular carcinoma (HCC) is the sixth major malignant tumor in the world and the third tumor leading to deaths. The low necrosis rate of local tumor after TACE is an important factor leading to tumor recurrence and metastasis and affecting the long-term postoperative efficacy (Georgiades et al, 2008; Takaki et al, 2009; Miyayama et al, 2010; Forner et al, 2012). Compared with simple TACE, combination of TACE and radiofrenquency ablation (RFA) can improve the treatment efficacy for large HCC and long-term survival rate of patients (Yamakado et al, 2002; Wang et al, 2010; Fan et al, 2011). Application of TACE combined with C-arm CT guided synchronous RFA to treatment of unresectable large HCC or huge HCC has not been reported. A retrospective study on 21 patients with large HCC from January 2010 to March 2012 was conducted, and the safety and preliminary clinical efficacy of combined treatment in treatment of large HCC were evaluated
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