比较射频间质热消融术阻抗控制与温度控制治疗小肝癌疗效的随机对照试验

Randomized Controlled Trial Comparing the Efficacy of Impedance Control and Temperature Control of Radiofrequency Interstitial Thermal Ablation for Treating Small Hepatocellular Carcinoma.

作者信息

Fukushima Taito, Ikeda Kenji, Kawamura Yusuke, Sorin Yushi, Hosaka Tetsuya, Kobayashi Masahiro, Saitoh Satoshi, Sezaki Hitomi, Akuta Norio, Suzuki Fumitaka, Suzuki Yoshiyuki, Arase Yasuji, Kumada Hiromitsu

机构信息

Department of Hepatology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan.

出版信息

Oncology. 2015;89(1):47-52. doi: 10.1159/000375166. Epub 2015 Mar 12.

DOI:10.1159/000375166

PMID:25790846

Abstract

OBJECTIVES

A randomized controlled trial was conducted to evaluate the efficacy of impedance control of a radiofrequency interstitial thermal ablation system (RITA) used to treat hepatocellular carcinoma (HCC).

METHODS

Fifteen patients with hypervascular HCCs <20 mm in diameter were randomly treated with radiofrequency ablation (RFA) using conventional temperature control (group A) or impedance control methods (group B). RITA needle electrodes were used in all cases. We compared ablation time, extent of lesion ablation, and energy use between the two groups.

RESULTS

The median long and short diameters of the axial cross sections of radiofrequency-induced necrotic areas visualized by CT were 32 mm (range, 26-36) and 25 mm (20-31) in group A and 32 mm (28-40) and 31 mm (24-37) in group B, respectively. The short diameter of group B patients was significantly greater than that of group A patients (p = 0.029). The median ablation time was 18.8 min in group A and 13.4 min in group B, thus significantly shorter in group B (p = 0.001). The energy requirement did not differ significantly between the groups.

CONCLUSIONS

Impedance control of the RITA system resulted in an increased size of the ablation zone and a decreased ablation time.

摘要

目的

开展一项随机对照试验，以评估用于治疗肝细胞癌（HCC）的射频间质热消融系统（RITA）的阻抗控制疗效。

方法

15例直径<20 mm的富血管性肝癌患者被随机分为两组，分别采用传统温度控制（A组）或阻抗控制方法（B组）进行射频消融（RFA）治疗。所有病例均使用RITA针电极。我们比较了两组之间的消融时间、病灶消融范围和能量使用情况。

结果

CT显示的射频诱导坏死区域轴向横截面的长径和短径中位数，A组分别为32 mm（范围26 - 36）和25 mm（20 - 31），B组分别为32 mm（28 - 40）和31 mm（24 - 37）。B组患者的短径显著大于A组患者（p = 0.029）。A组的中位消融时间为18.8分钟，B组为13.4分钟，因此B组显著更短（p = 0.001）。两组之间的能量需求无显著差异。