肝癌≥5cm组合疗法:微波消融立即肝动脉化疗栓塞紧随后

StephenW

J Vasc Interv Radiol. 2016 Apr 18. pii: S1051-0443(16)00287-6. doi: 10.1016/j.jvir.2016.02.014. [Epub ahead of print]
Combination Therapies in the Management of Large (≥ 5 cm) Hepatocellular Carcinoma: Microwave Ablation Immediately Followed by Transarterial Chemoembolization.
Si ZM1, Wang GZ2, Qian S1, Qu XD1, Yan ZP1, Liu R1, Wang JH3.
Author information

    1Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
    2Department of Intervention Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
    3Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: [email protected].

Abstract
PURPOSE:

To evaluate the safety and efficacy of microwave (MW) ablation combined with transarterial chemoembolization in a single stage for the treatment of large (≥ 5 cm) hepatocellular carcinoma (HCC).
MATERIALS AND METHODS:

From March 2013 to January 2015, 66 patients (54 men and 12 women; mean age, 54 y; range, 29-83 y) with 72 large HCC lesions were included in this study. Eighteen (27.3%) had Barcelona Clinic Liver Cancer class B disease, and 48 (72.7%) had class C disease. Seventy-nine percent of patients (n = 52) had hepatitis B virus infection. The average tumor size was 9.0 cm ± 3.9, ranging from 5 to 19 cm. MW ablation was performed under ultrasound guidance, immediately followed by chemoembolization. Local tumor response, progression-free survival (PFS), and overall survival (OS) were assessed.
RESULTS:

The technique was successfully performed in all patients. Complete response (CR) was achieved in 28 cases (42.4%), and partial response (PR) was achieved in 34 cases (51.5%) at 1 month after the procedure. The objective response rate (ie, CR plus PR) was 93.9%. Median PFS and OS times were 9 months and 21 months, respectively. The 6-, 12-, and 18-month OS rates were 93.9%, 85.3%, and 66.6%, respectively. Hemorrhage was detected in three patients and arteriovenous fistula in two patients after MW ablation; all were promptly treated with embolization. There were no liver abscesses, bile-duct injuries, or other major procedure-related complications.
CONCLUSIONS:

MW ablation immediately followed by chemoembolization is safe and effective in the treatment of large HCC lesions.

Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

StephenW

ĴVASC INTERV放射学杂志。 2016年18月PII：S1051-0443（16）00287-6。 DOI：10.1016 / j.jvir.2016.02.014。 [打印EPUB提前]
在肝癌的大（≥5厘米）的管理组合疗法：微波消融立即肝动脉化疗栓塞紧随其后。
思ZM1，王GZ2，钱S1，曲XD1，严ZP1，刘R1，王JH3。
作者信息

    医学影像与介入放射科，中山医院，复旦大学，上海，中国的1Shanghai研究所。
    介入放射科，复旦大学上海癌症研究中心，上海，中国的教研室。
    医学影像与介入放射科，中山医院，复旦大学，上海，中国的3Shanghai研究所。电子地址：[email protected]。

抽象
目的：

来评价安全性和微波（MW）的消融化学栓塞在单一阶段合并为大（≥5厘米）肝细胞癌（HCC）的治疗中的功效。
材料和方法：

从三月2013至2015年一月，66例（54男12女，平均年龄54岁，范围29-83 y）的72大肝癌病灶被列入这项研究。十八（27.3％）有巴塞罗那临床肝癌B类疾病，48（72.7％）有C类疾病。患者的79％（N = 52）有乙肝病毒感染。的平均肿瘤大小为9.0厘米±3.9，范围从5至19厘米超声引导下进行消融兆瓦，紧接着化疗栓塞。肿瘤局部反应，无进展生存期（PFS）和总生存期（OS）进行了评估。
结果：

所有患者均顺利完成技术。完全反应（CR）28例（42.4％）达到了，和部分缓解（PR）中的34例（51.5％），在手术后1个月来实现。客观缓解率（即CR加PR）为93.9％。中位PFS和OS时间分别为9个月21个月分别。所述6-，12-，和18个月的OS率分别为93.9％，85.3％，和66.6％。 3例和MW消融后两名患者动静脉瘘检测出血;所有人都及时与栓塞治疗。目前还没有肝脓肿，胆管损伤，或其他重大手术相关的并发症。
结论：

MW消融紧接着化疗栓塞是安全，有效的大肝癌病灶的治疗。

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