Sakr Ayman A, Saleh Alaa Ahmed, Moeaty Amr Ali Abdel, Moeaty Ali Abdel
Department of Radiation Sciences, Radiology Unit, Medical Research Institute, University of Alexandria, 165 Horreya Avenue, El Hadara, Alexandria, Egypt.
Eur J Radiol. 2005 Jun;54(3):418-25. doi: 10.1016/j.ejrad.2004.06.008.
Only a small percentage of patients with large hepatocellular carcinoma (HCC) may benefit out of surgical resection. Thus, most of these patients are in need of a form of local control, such as ethanol ablation, transarterial chemoembolization (TACE), radiofrequency thermal ablation (RF), or laser induced thermotherapy (LITT). The purpose of this study was to assess the short-term effect of sequential RF and ethanol ablation in the management of large HCC (>5 cm). Our series included 40 patients with large HCC tumors (>5 cm in diameter). We adopted a protocol of overlapping RF applications, followed by repeated ethanol ablation sessions. Our results showed that the volume of tumor coagulative necrosis initially induced by RF has significantly risen after adjuvant ethanol ablation sessions (P < 0.001). Patients who achieved complete tumor necrosis after RF ablation were 52.5% of the series. This percent has jumped to 80% of the series at the end of the protocol. This indicates that such combined protocol is more effective than RF alone. Besides, it is valuable in reducing the number of RF sessions.
只有一小部分大肝细胞癌（HCC）患者可能从手术切除中获益。因此，这些患者中的大多数需要某种形式的局部控制，如乙醇消融、经动脉化疗栓塞（TACE）、射频热消融（RF）或激光诱导热疗（LITT）。本研究的目的是评估序贯RF和乙醇消融在治疗大肝癌（>5 cm）中的短期效果。我们的系列研究纳入了40例大肝癌患者（直径>5 cm）。我们采用了重叠RF应用方案，随后进行重复乙醇消融治疗。我们的结果显示，辅助乙醇消融治疗后，最初由RF诱导的肿瘤凝固性坏死体积显著增加（P < 0.001）。在该系列研究中，RF消融后实现肿瘤完全坏死的患者占52.5%。在该方案结束时，这一比例跃升至该系列的80%。这表明这种联合方案比单独使用RF更有效。此外，它在减少RF治疗次数方面具有重要价值。
