Péter Mózes, Tóth Judit, Péter Mózes, Sápy Péter, András Csilla
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Altalános Orvostudomnyi Kar, Radiológiai Klinika.
Orv Hetil. 2002 Sep 29;143(39):2229-34.
A lot of different methods exist for the treatment of liver primary and secondary tumours. Nowadays surgery is the method of choice. If operation is not possible and other conditions are available, local tumour ablation is applicable. One of these methods is the radio-frequency (RF) thermal ablation.
This method is effective on the base of literature, albeit the indications are not uniform. Authors by the own experience wanted to get dates to define the indication and to study the effectivity of this method in the therapy of liver tumour.
PATIENTS/METHODS: Between the 1 January 2000 and 31 January 2002, 86 tumors of 40 patients were treated with RF thermal tumour ablation. This method was applied first in Hungary by our workgroup. RF ablation was performed with generator Cosman CC-1, Radionics, Burlington and cooled-tip single or cluster electrodes.
Complete response was achieved in 56 percent. Results of primary tumour necrosis was better when the diameter of the tumour was 3.5-4 cm or less or the treatment was achieved by cluster electrode. 20 patients became tumour free (5 have breast cancer). Tumour spread came into existence in the spite of therapy in ten patients, 8 patients died. The average observation time was one year. In conclusion, the results of this study show that RF ablation with a cooled-tip electrode needle is a safe and effective technique for local treatment of hepatic lesions 4 cm or less in diameter and if the number of lesion less than 4-5.
Authors suggest to use widely the RF technique with other methods in the treatment of hepatic tumours.
治疗肝脏原发性和继发性肿瘤有许多不同的方法。如今，手术是首选方法。如果无法进行手术且具备其他条件，则可采用局部肿瘤消融术。其中一种方法是射频（RF）热消融术。
尽管该方法的适应症并不统一，但从文献来看它是有效的。作者凭借自身经验希望获取数据以明确适应症，并研究该方法在肝脏肿瘤治疗中的有效性。
患者/方法：在2000年1月1日至2002年1月31日期间，对40例患者的86个肿瘤进行了射频热肿瘤消融治疗。我们的工作小组在匈牙利首次应用了这种方法。使用Cosman CC - 1发生器、Radionics公司位于伯灵顿的产品以及冷端单电极或集束电极进行射频消融。
56%的患者实现了完全缓解。当肿瘤直径为3.5 - 4厘米或更小时，或采用集束电极进行治疗时，原发性肿瘤坏死的效果更好。20例患者实现了无瘤状态（5例为乳腺癌）。尽管进行了治疗，仍有10例患者出现肿瘤扩散，8例患者死亡。平均观察时间为一年。总之，本研究结果表明，使用冷端电极针进行射频消融是一种安全有效的技术，可用于局部治疗直径4厘米及以下且病灶数量少于4 - 5个的肝脏病变。
作者建议在肝脏肿瘤治疗中广泛将射频技术与其他方法联合使用。
