Bale Reto, Schullian Peter, Haidu Marion, Widmann Gerlig
Abteilung für Mikroinvasive Therapie - SIP Univ.-Klinik für Radiodiagnostik, Universitätsklinik Innsbruck, Medizinische Universität Innsbruck, Anichstraße 35, Innsbruck, Österreich.
Wien Med Wochenschr. 2013 Mar;163(5-6):128-31. doi: 10.1007/s10354-013-0182-8. Epub 2013 Feb 8.
Up to now resection and liver transplantation are concerned as the only curative treatment options for intrahepatic cholangiocellular carcinomas (ICCs). For patients with inoperable ICCs systemic chemotherapy and various locoregional therapies including transarterial (chemo)embolization (TACE), selective internal radiation therapy (SIRT), radiofrequency ablation (RFA) and microwave ablation (MWA) are applied. Stereotactic RFA (SRFA) allows for precise 3D planning and positioning of multiple RF electrodes. Due to overlapping necroses tumors > 5 cm can be completely ablated in one session. 17 inoperable consecutive patients with 52 ICCs were treated with stereotactic RFA (SRFA). A median overall survival of 60 months was achieved. The two largest tumors with diameters > 10 cm were completely ablated. These SRFA data of irresectable ICCs are superior to the published data on resection. SRFA is a minimal invasive alternative treatment to resection and may be considered as the first-line local treatment of patients with ICCs in selected patients.
到目前为止,肝内胆管细胞癌(ICCs)的唯一根治性治疗选择是手术切除和肝移植。对于无法手术的ICCs患者,采用全身化疗和各种局部治疗,包括经动脉(化疗)栓塞(TACE)、选择性内放射治疗(SIRT)、射频消融(RFA)和微波消融(MWA)。立体定向RFA(SRFA)允许对多个射频电极进行精确的三维规划和定位。由于坏死区域重叠,直径>5 cm的肿瘤可在一次治疗中完全消融。对17例连续的无法手术的患者的52个ICCs进行了立体定向RFA(SRFA)治疗。中位总生存期达到60个月。两个最大直径>10 cm的肿瘤被完全消融。这些无法切除的ICCs的SRFA数据优于已发表的手术切除数据。SRFA是一种微创的手术替代治疗方法,在特定患者中可被视为ICCs患者的一线局部治疗方法。