Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China.
Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China.
Cancer Imaging. 2020 Jan 30;20(1):13. doi: 10.1186/s40644-020-0294-5.
To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC).
From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS).
The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test).
Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.
评估经导管动脉化疗栓塞（TACE）联合同期 DynaCT 引导下微波消融（MWA）治疗小肝细胞癌（SHCC）的方法和疗效。
2015 年 6 月至 2017 年 5 月，共 28 例连续的 SHCC 患者接受 TACE 单一治疗，23 例患者接受 TACE 联合同期 DynaCT 引导下 MWA 治疗。治疗 1 个月后，采用 mRECIST 标准评估肿瘤反应，并分析包括与干预相关的并发症、肝功能变化、影像学反应和无进展生存期（PFS）在内的结果。
技术成功率为 100%。联合 TACE 和 MWA 组的完全缓解率（65%）高于 TACE 组（46%）。联合 TACE 和 MWA 组常见不良事件（如肝脓肿、自发性细菌性腹膜炎和肝功能障碍）的发生率（56%）与 TACE 组相当（P＞0.411）。TACE 组的中位和平均 PFS 明显低于联合 TACE 和 MWA 组（19.00 个月 vs. 29.00 个月，21.076 个月 vs. 24.693 个月，p=0.019，log-rank 检验）。
立体定向 DynaCT 引导下 MWA 是治疗 SHCC 的一种安全有效的方法，通常能提供有效的肿瘤穿刺路径，尤其适用于 TACE 后无法检测到的病变。总体而言，该治疗方法可改善 SHCC 患者的临床结局。
