Department of Interventional Radiology, Gustave Roussy-Cancer Center, 94805 Villejuif, France.
Department of Interventional Radiology, Gustave Roussy-Cancer Center, 94805 Villejuif, France; University of Paris-Saclay, 91190 Saint-Aubin, France.
Diagn Interv Imaging. 2022 Nov;103(11):516-523. doi: 10.1016/j.diii.2022.05.008. Epub 2022 Jun 14.
The purpose of this study was to evaluate the safety and efficacy of transarterial chemoembolization (TACE) combined with percutaneous thermal ablation in patients with liver metastases 3 cm in diameter or larger.
This retrospective study included 39 patients with a total of 46 liver metastases treated. There were 14 men and 25 women, with a mean age of 55 ± 13.3 (SD) (age range: 28-77 years). All patients were treated with a combination of TACE and thermal ablation in a single session. Primary outcome was local tumor progression. Secondary outcomes were procedure related complications and systemic disease progression.
Mean tumor size was 3.6 ± 0.6 (SD) cm (range: 3-5 cm). Conventional TACE was performed in 32 liver metastases (32/46; 70%) and drug-eluting beads-TACE in 14 liver metastases (14/46; 30%) followed by radiofrequency ablation in 34 (34/46; 74%), microwave ablation in 11 (11/46; 24%) and cryoablation in one (1/46; 2%) metastasis. Four grade 2 (4/39; 10%) complications were observed. After a mean follow up of 31.9 ± 26.1 (SD) months (range: 2-113 months) overall local tumor progression rate was 15% (7/46). Local tumor progression rate at 12 months was 13% (6/46). Overall systemic disease progression was seen in 29 patients (29/39; 74%) with a systemic disease progression rate at 12 months of 59% (23/39).
Treatment of large liver metastases with TACE and thermal ablation in a single session is safe and achieves high local control rate.
本研究旨在评估经动脉化疗栓塞（TACE）联合经皮热消融治疗直径 3cm 或更大的肝转移瘤的安全性和疗效。
本回顾性研究纳入了 39 例共 46 个肝转移灶患者。其中男性 14 例，女性 25 例，平均年龄 55 ± 13.3（SD）（年龄范围：28-77 岁）。所有患者均在单次治疗中接受 TACE 和热消融联合治疗。主要结局为局部肿瘤进展。次要结局为与治疗相关的并发症和全身疾病进展。
平均肿瘤大小为 3.6 ± 0.6（SD）cm（范围：3-5cm）。32 个肝转移灶（32/46；70%）行常规 TACE，14 个肝转移灶（14/46；30%）行载药微球 TACE，随后 34 个（34/46；74%）行射频消融，11 个（11/46；24%）行微波消融，1 个（1/46；2%）行冷冻消融。观察到 4 例 2 级（4/39；10%）并发症。中位随访时间为 31.9 ± 26.1（SD）个月（范围：2-113 个月），总局部肿瘤进展率为 15%（7/46）。12 个月时的局部肿瘤进展率为 13%（6/46）。29 例患者（29/39；74%）出现全身疾病进展，12 个月时的全身疾病进展率为 59%（23/39）。
单次 TACE 和热消融治疗大肝转移瘤是安全的，可获得较高的局部控制率。
