Shiraishi Ryu, Yamasaki Takahiro, Saeki Issei, Okita Kohsuke, Yamaguchi Yuhki, Uchida Koichi, Terai Shuji, Sakaida Isao
Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Am J Clin Oncol. 2008 Aug;31(4):311-6. doi: 10.1097/COC.0b013e31815e4539.
We have reported that radiofrequency (RF) ablation with balloon occlusion of the hepatic artery (balloon-occluded RF ablation) increases the coagulation area compared with standard RF ablation. In this study, we evaluated the efficacy and safety of combination therapy with transcatheter arterial infusion chemotherapy (TAI) using iodized oil and balloon-occluded RF ablation in patients with hepatocellular carcinoma.
We studied 12 patients with 12 HCC nodules (mean tumor diameter, 27.3 mm). All patients were classified as Child-Pugh Class A. Immediately after TAI using iodized oil, we performed balloon-occluded RF ablation.
One treatment session of the combination therapy was done for 10 of 12 nodules (83%). The greatest long-axis and short-axis dimensions of the area coagulated after the combination therapy were 48.8+/- 5.5 mm and 41.9 +/- 4.1 mm, respectively. During follow-up (mean, 33.4 months), there was no local recurrence. The 1, 2, and 3-year survival rates were 100%, 92%, and 83%, respectively. No fatal complications were observed.
The combination therapy is an effective and safe treatment under favorable liver reserve capacity. Using the combination therapy, it is possible to finish one treatment session for patients with HCC nodules measuring less than 3 cm in greatest dimension.
我们曾报道，与标准射频消融相比，采用肝动脉球囊闭塞的射频消融术（球囊闭塞射频消融）可增加凝固面积。在本研究中，我们评估了经动脉化疗栓塞术（TAI）联合碘化油及球囊闭塞射频消融术治疗肝细胞癌患者的疗效和安全性。
我们研究了12例患有12个肝癌结节的患者（平均肿瘤直径27.3毫米）。所有患者均为Child-Pugh A级。在使用碘化油进行TAI后，立即进行球囊闭塞射频消融。
12个结节中的10个（83%）接受了一次联合治疗。联合治疗后凝固区域的最大长轴和短轴尺寸分别为48.8±5.5毫米和41.9±4.1毫米。在随访期间（平均33.4个月），无局部复发。1年、2年和3年生存率分别为100%、92%和83%。未观察到致命并发症。
在肝脏储备功能良好的情况下，联合治疗是一种有效且安全的治疗方法。采用联合治疗，对于最大直径小于3厘米的肝癌结节患者，有可能完成一次治疗疗程。
