Department of Interventional Radiology, The First Medical Center of PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
Abdom Radiol (NY). 2020 Aug;45(8):2585-2592. doi: 10.1007/s00261-020-02462-1.
To evaluate the rapeutic effectiveness of Angio-CT or cone-beam CT (CBCT)-guided immediate radiofrequency ablation (RFA) after transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma (HCC).
117 large HCC patients (mean maximum diameter: 9.3 cm; range 5.3-17.7 cm) were retrospective studied and divided into Angio-CT group (n = 66 cases), CBCT group (n = 21 cases), and single TACE group (n = 30 cases) according to treatment (Angio-CT/CBCT-guided immediate RFA after TACE, single TACE, respectively). The operative time, effective radiation dose, local-regional tumor responses, overall survival (OS), and progression‑free survival (PFS) time and complications were recorded.
The operative time and effective radiation dose of Angio-CT group and CBCT group were higher than those of TACE group (P < 0.01). The local-regional tumor responses on 1-month follow-up MRI (complete response + partial response) of Angio-CT group and CBCT group were 100%, which were significantly higher than that of single TACE group (76.7%, P < 0.05). There was no significant difference in local-regional tumor responses of 1-month follow-up between Angio-CT group and CBCT group (P = 0.831). The median PFS and OS time of Angio-CT group were 14.7 ± 1.43 months and 18.21 ± 0.88 months, CBCT group were 13.9 ± 1.53 months and 17.87 ± 1.78 months, TACE group were 10.4 ± 1.21 months and 12.87 ± 0.91 months, respectively. No procedure-related major complications occurred.
MIYABI Angio-CT or CBCT-guided immediate RFA after TACE for large HCC both have more effective than single TACE. The former is worth popularizing, due to its advantages of convenience, shorter operative time, and less radiation dose for doctors.
评估血管造影 CT 或锥形束 CT（CBCT）引导的经导管肝动脉化疗栓塞（TACE）后即刻射频消融（RFA）治疗大肝癌（HCC）的疗效。
回顾性分析 117 例大 HCC 患者（最大直径平均：9.3cm；范围 5.3-17.7cm），根据治疗方法分为血管造影 CT 组（n=66 例）、CBCT 组（n=21 例）和单纯 TACE 组（n=30 例）（分别为血管造影 CT/CBCT 引导的即刻 TACE 后 RFA、单纯 TACE）。记录手术时间、有效辐射剂量、局部肿瘤反应、总生存期（OS）和无进展生存期（PFS）时间及并发症。
血管造影 CT 组和 CBCT 组的手术时间和有效辐射剂量均高于 TACE 组（P<0.01）。血管造影 CT 组和 CBCT 组 1 个月时 MRI 随访的局部肿瘤反应（完全缓解+部分缓解）均为 100%，明显高于单纯 TACE 组（76.7%，P<0.05）。血管造影 CT 组和 CBCT 组 1 个月时局部肿瘤反应差异无统计学意义（P=0.831）。血管造影 CT 组中位 PFS 和 OS 时间分别为 14.7±1.43 个月和 18.21±0.88 个月，CBCT 组分别为 13.9±1.53 个月和 17.87±0.78 个月，TACE 组分别为 10.4±1.21 个月和 12.87±0.91 个月。无与治疗相关的严重并发症发生。
MIYABI 血管造影 CT 或 CBCT 引导的 TACE 后即刻 RFA 治疗大 HCC 均优于单纯 TACE。前者操作简便、手术时间短、医生辐射剂量小，值得推广。
