Buscarini L, Buscarini E
Gastroenterology Department, Hospital of Piacenza, Italy.
Hepatogastroenterology. 2001 Jan-Feb;48(37):15-9.
Radiofrequency interstitial hyperthermia has been used for percutaneous ablation of hepatocellular carcinoma, under ultrasound guidance in local anesthesia. Conventional needle electrodes require a mean number of 3 sessions to treat tumors of diameter < or = 3 cm. Tumors up to 3.5 cm in diameter can be treated in 1 or 2 sessions by expandable needle electrodes. With both methods in all treated cases, ablation of tumors was obtained. In a group of patients with long follow-up, survival rate at 5 years was 40%. In a mean follow-up of 23 months 41% of patients had recurrences (local recurrences in 5%; new lesions in 36%), which often could be retreated by a new course of radiofrequency application. In recent experience large hepatocellular carcinomas (up to 6.8 cm in diameter) were treated by a combination of segmental transcatheter arterial embolization followed by radiofrequency application. In this way most tumors were ablated in one session of radiofrequency therapy. No fatal complications were observed. Major complications were: strong pain due to capsular necrosis in one patient; hemotorax in one case; a fluid collection in the site of ablated tumor in one patient treated by combination of transcatheter arterial embolization and radiofrequency application.
射频间质热疗已用于在局部麻醉下经超声引导对肝细胞癌进行经皮消融。传统针电极治疗直径≤3 cm的肿瘤平均需要3次治疗。直径达3.5 cm的肿瘤可通过可扩张针电极在1或2次治疗中得到治疗。使用这两种方法，在所有治疗病例中均实现了肿瘤消融。在一组长期随访的患者中，5年生存率为40%。平均随访23个月时，41%的患者出现复发（局部复发占5%；新病灶占36%），这些复发灶通常可通过新一轮射频治疗进行再次治疗。在最近的经验中，大型肝细胞癌（直径达6.8 cm）通过先行节段性经导管动脉栓塞术再进行射频治疗的联合方法进行治疗。通过这种方式，大多数肿瘤在一次射频治疗中即被消融。未观察到致命并发症。主要并发症包括：1例患者因包膜坏死出现剧痛；1例出现血胸；1例接受经导管动脉栓塞术和射频治疗联合治疗的患者在消融肿瘤部位出现积液。
