Lencioni Riccardo, Crocetti Laura, Petruzzi Pasquale, Vignali Claudio, Bozzi Elena, Della Pina Clotilde, Bargellini Irene, Cioni Dania, Oliveri Filippo, De Simone Paolo, Bartolozzi Carlo, Brunetto Maurizia, Filipponi Franco
Division of Diagnostic and Interventional Radiology, Department of Oncology and Radiology, Cisanello University Hospital - Building No. 9, Via Paradisa 2, IT-56124 Pisa, Italy.
J Hepatol. 2008 Aug;49(2):217-22. doi: 10.1016/j.jhep.2008.03.021. Epub 2008 Apr 24.
BACKGROUND/AIMS: Experimental studies have shown synergy between radiofrequency (RF) ablation and adjuvant chemotherapy in animal tumour models. We aimed to assess safety and efficacy of doxorubicin-eluting bead (DEB)-enhanced RF ablation in the treatment of human hepatocellular carcinoma (HCC).
Twenty patients with single HCC ranging 3.3-7.0 cm (mean, 5.0 cm+/-1.4) showing evidence of residual viable tumour after standard RF ablation underwent intraarterial DEB administration (50-125 mg doxorubicin; mean, 60.2 mg+/-21.8). Follow-up period ranged 6-20 months (mean, 12 months+/-5).
No major complication occurred. No deterioration of liver function was observed. The volume of treatment-induced necrosis--as measured on imaging--increased from 48.1 cm3+/-35.7 after RF ablation to 75.5 cm3+/-52.4 after DEB administration, with an increase of 60.9%+/-39.0. The enhanced effect resulted in confirmed complete response (CR) of the target lesion in 12 (60%) of 20 patients. Incomplete response with persistence of <10% of initial tumour volume was observed in 6 (30%) of 20 patients, and local tumour progression in 2 (10%) of 20.
Intraarterial DEB administration substantially enhances the effect of RF ablation. DEB-enhanced RF ablation is safe and results in a high rate of CR in patients refractory to standard RF treatment.
背景/目的：实验研究表明，在动物肿瘤模型中，射频（RF）消融与辅助化疗之间存在协同作用。我们旨在评估载药微球（DEB）增强射频消融治疗人类肝细胞癌（HCC）的安全性和疗效。
20例单发HCC患者，肿瘤大小为3.3 - 7.0 cm（平均5.0 cm±1.4），在标准射频消融后显示有残余存活肿瘤，接受动脉内DEB给药（阿霉素50 - 125 mg；平均60.2 mg±21.8）。随访期为6 - 20个月（平均12个月±5）。
未发生重大并发症。未观察到肝功能恶化。影像学测量显示，治疗引起的坏死体积从射频消融后的48.1 cm³±35.7增加到DEB给药后的75.5 cm³±52.4，增加了60.9%±39.0。增强效果使20例患者中的12例（60%）目标病灶得到确认完全缓解（CR）。2（10%）。
动脉内DEB给药显著增强了射频消融的效果。DEB增强射频消融是安全的，并且在对标准射频治疗难治的患者中导致高CR率。 20例患者中有6例（30%）出现不完全缓解，初始肿瘤体积的<10%持续存在，20例患者中有2例（10%）出现局部肿瘤进展。
