Curley S A, Izzo F, Delrio P, Ellis L M, Granchi J, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Ann Surg. 1999 Jul;230(1):1-8. doi: 10.1097/00000658-199907000-00001.
To describe the safety and efficacy of radiofrequency ablation (RFA) to treat unresectable malignant hepatic tumors in 123 patients.
The majority of patients with primary or metastatic malignancies confined to the liver are not candidates for resection because of tumor size, location, or multifocality or inadequate functional hepatic reserve. Local application of heat is tumoricidal; therefore, the authors investigated a novel RFA system to treat patients with unresectable hepatic cancer.
Patients with hepatic malignancies were entered into a prospective, nonrandomized trial. The liver tumors were treated percutaneously or during surgery under ultrasound guidance using a novel LeVeen monopolar array needle electrode and an RF 2000 generator. All patients were followed to assess complications, treatment response, and recurrence of malignant disease.
RFA was used to treat 169 tumors (median diameter 3.4 cm, range 0.5 to 12 cm) in 123 patients. Primary liver cancer was treated in 48 patients (39.1%), and metastatic liver tumors were treated in 75 patients (60.9%). Percutaneous and intraoperative RFA was performed in 31 patients (35.2%) and 92 patients (74.8%), respectively. There were no treatment-related deaths, and the complication rate after RFA was 2.4%. All treated tumors were completely necrotic on imaging studies after completion of RFA treatments. With a median follow-up of 15 months, tumor has recurred in 3 of 169 treated lesions (1.8%), but metastatic disease has developed at other sites in 34 patients (27.6%).
RFA is a safe, well-tolerated, and effective treatment to achieve tumor destruction in patients with unresectable hepatic malignancies. Because patients are at risk for the development of new metastatic disease after RFA, multimodality treatment approaches that include RFA should be investigated.
描述射频消融（RFA）治疗123例不可切除恶性肝肿瘤的安全性和有效性。
大多数局限于肝脏的原发性或转移性恶性肿瘤患者因肿瘤大小、位置、多灶性或肝储备功能不足而不适合手术切除。局部热应用具有杀肿瘤作用；因此，作者研究了一种新型RFA系统来治疗不可切除肝癌患者。
肝恶性肿瘤患者进入一项前瞻性、非随机试验。在超声引导下经皮或手术中使用新型LeVeen单极阵列针电极和RF 2000发生器治疗肝肿瘤。对所有患者进行随访，以评估并发症、治疗反应和恶性疾病复发情况。
RFA用于治疗123例患者的169个肿瘤（中位直径3.4 cm，范围0.5至12 cm）。48例（39.1%）患者治疗原发性肝癌，75例（60.9%）患者治疗转移性肝肿瘤。分别有31例（35.2%）和92例（74.8%）患者接受了经皮和术中RFA。无治疗相关死亡，RFA后的并发症发生率为2.4%。RFA治疗完成后，所有治疗的肿瘤在影像学检查中均完全坏死。中位随访15个月，169个治疗病灶中有3个（1.8%）复发，但34例（27.6%）患者在其他部位出现了转移性疾病。
RFA是一种安全、耐受性良好且有效的治疗方法，可实现不可切除肝恶性肿瘤患者的肿瘤破坏。由于RFA后患者有发生新的转移性疾病的风险，应研究包括RFA在内的多模式治疗方法。
