Sheta Elshazly, El-Kalla Ferial, El-Gharib Mohamed, Kobtan Abdelrahman, Elhendawy Mohammed, Abd-Elsalam Sherief, Mansour Loai, Amer Ibrahim
aDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta bDepartment of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Eur J Gastroenterol Hepatol. 2016 Oct;28(10):1198-203. doi: 10.1097/MEG.0000000000000688.
Globally, hepatocellular carcinoma (HCC) is the third most frequent cause of cancer-related mortality. In recent years, transarterial chemoembolization, radiofrequency ablation, and microwave ablation (MWA) have been accepted as treatment modalities for patients with surgically unresectable HCC.
This study aimed to compare combination treatment with radiofrequency or MWA, followed by transarterial chemoembolization, and performed in a single session.
This study was carried out on 50 patients with nonresectable single-lesion HCC, who were divided into three groups: group A included 20 patients treated by transcatheter hepatic arterial chemoembolization, group B included 20 patients treated by radiofrequency thermal ablation combined with transcatheter arterial chemoembolization, and group C included 10 patients treated by MWA combined with transcatheter arterial chemoembolization. The combined treatments were performed in a single session, with the ablation performed first.
The total success rate in this study at 6 months following the procedure was 50% in group A, 70% in group B, and 80% in group C. Major complications were recorded in 22% of patients. The number of complications was the highest in group A.
Combined ablation with chemoembolization is superior in the treatment of nonresectable single masses larger than 4 cm. Transcatheter arterial chemoembolization and ablation can be performed safely and successfully during a single session, which has not been found to decrease the response rates to treatment. Combined treatment with MWA is more effective in terms of tumor response, and results in the same complication rate as with radiofrequency, but less than chemoembolization alone.
在全球范围内，肝细胞癌（HCC）是癌症相关死亡的第三大常见原因。近年来，经动脉化疗栓塞、射频消融和微波消融（MWA）已被公认为不可手术切除的HCC患者的治疗方式。
本研究旨在比较射频或MWA联合经动脉化疗栓塞的单次治疗效果。
本研究对50例不可切除的单发性HCC患者进行，分为三组：A组包括20例接受经导管肝动脉化疗栓塞治疗的患者，B组包括20例接受射频热消融联合经导管动脉化疗栓塞治疗的患者，C组包括10例接受MWA联合经导管动脉化疗栓塞治疗的患者。联合治疗在单次治疗中进行，先进行消融。
本研究术后6个月的总成功率在A组为50%，B组为70%，C组为80%。22%的患者出现了主要并发症。并发症数量在A组最高。
消融联合化疗栓塞在治疗直径大于4 cm的不可切除单发性肿块方面更具优势。经导管动脉化疗栓塞和消融可以在单次治疗中安全、成功地进行，且未发现会降低治疗反应率。MWA联合治疗在肿瘤反应方面更有效，并发症发生率与射频相同，但低于单纯化疗栓塞。
