Panpikoon Tanapong, Treesit Tharintorn, Thapaneeyakorn Jiemjit, Wedsart Banjongsak, Inman Thanipa
Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2013 Jan;96(1):77-82.
Evaluate the efficacy of percutaneous radiofrequency ablation ofhepatic malignant tumors.
An ultrasound-guided percutaneous radiofrequency ablation using a 17-gauge single needle perfusedcooled electrode (Cool-tip) RF ablation system was performed on 30 hepatic tumors in 26 patients between January 2009 and September 2010. The medical records, CT scan, and MRI results were assessed at one and three months after the procedure was completed. Primary technical success, local tumor progression, and complication were also evaluated.
Twenty-six hepatic lesions in 23 patients were primarily hepatocellular carcinoma. Only four lesions in three patients were metastasized. Three of them were from colorectal cancer whilst another one was from malignant melanoma. At 1-month follow-up imaging post percutaneous radiofrequency ablation, complete ablation rate was 86.7%. Local tumor progression at 3-month follow-up imaging was 4.2%. The rate for minor complication was 3.8%. No major complication was found Complete ablation rate was found to increase signiJicantly in tumors size of less than 2 cm compared to those diameter larger than 2 cm (p < 0.05).
Percutaneous radiofrequency ablation is one of the most effective and invulnerable therapeutic modality in treatment of hepatic malignant tumor. Size is the key factor of technical success as the smaller the size of tumor the better the outcome achieved.
评估经皮射频消融治疗肝脏恶性肿瘤的疗效。
2009年1月至2010年9月期间，对26例患者的30个肝脏肿瘤采用17G单针水冷电极（冷循环电极）射频消融系统进行超声引导下经皮射频消融治疗。在治疗完成后1个月和3个月时评估病历、CT扫描及MRI结果。同时评估主要技术成功率、局部肿瘤进展情况及并发症。
23例患者的26个肝脏病灶主要为肝细胞癌。仅3例患者的4个病灶为转移瘤。其中3个来自结直肠癌，另1个来自恶性黑色素瘤。经皮射频消融术后1个月随访影像检查时，完全消融率为86.7%。3个月随访影像检查时局部肿瘤进展率为4.2%。轻微并发症发生率为3.8%。未发现严重并发症。与直径大于2 cm的肿瘤相比，直径小于2 cm的肿瘤完全消融率显著升高（p<0.05）。
经皮射频消融是治疗肝脏恶性肿瘤最有效且安全的治疗方式之一。肿瘤大小是技术成功的关键因素，肿瘤越小，治疗效果越好。
