Yoshihara Terutaka, Hasegawa Takaaki, Sato Yozo, Yamaura Hidekazu, Murata Shinichi, Chatani Shohei, Tsukii Ryota, Nagasawa Kyohei, Tsushima Yoshito, Inaba Yoshitaka
Department of Diagnostic and Interventional Radiology, Aichi Cancer Center, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Japan.
Interv Radiol (Higashimatsuyama). 2023 Mar 1;8(1):7-13. doi: 10.22575/interventionalradiology.2022-0017.
To retrospectively evaluate the outcomes of radiofrequency ablation combined with transarterial chemoembolization using degradable starch microspheres for non-hepatocellular carcinoma malignant liver tumors.
A total of 15 patients (13 men, 2 women; median age, 67 years) who underwent radiofrequency ablation immediately after transarterial chemoembolization using degradable starch microspheres for liver tumors between July 2011 and September 2020 were included in this study. Thirteen patients had liver metastases from colorectal cancer (n = 6), esophageal cancer (n = 2), lung cancer (n = 2), and other tumors (n = 3), and 2 patients had primary liver tumor of cholangiocellular carcinoma (n = 1) and gastrinoma (n = 1). Twenty tumors (median size, 16 mm) were treated in 17 sessions. Technical success, safety, local tumor progression, and overall survival were evaluated. Safety was assessed according to the clinical practice guideline of the Society of Interventional Radiology.
All treatment procedures were successfully completed. There were no major complications. Grade-B complications of self-limiting pneumothorax (n = 1), vomiting (n = 1), and fever (n = 1) occurred in 1 session each. Local tumor progression developed in two tumors (local tumor progression rate, 10%, 2/20). The local tumor progression rates were 5% and 11% at 1 year and at 3 and 5 years, respectively. Tumor size of more than 20 mm ( = 0.0003) and contact with major vessels ( = 0.03) were significant risk factors for local tumor progression. The patients were treated with repeat radiofrequency ablation combined with transarterial chemoembolization using degradable starch microspheres. During median follow-up of 48 months (range, 4-77 months), 5 patients died (33%, 5/15). The overall survival rates were 100%, 85%, and 57% at 1, 3, and 5 years, respectively. The median overall survival time was 69 months.
Radiofrequency ablation combined with transarterial chemoembolization using degradable starch microspheres was safe and showed favorable local control for non-hepatocellular carcinoma malignant liver tumors.
回顾性评估使用可降解淀粉微球的射频消融联合经动脉化疗栓塞术治疗非肝细胞癌性恶性肝肿瘤的疗效。
本研究纳入了2011年7月至2020年9月期间15例患者（13例男性，2例女性；中位年龄67岁），这些患者在使用可降解淀粉微球对肝肿瘤进行经动脉化疗栓塞术后立即接受了射频消融治疗。13例患者有结直肠癌肝转移（6例）、食管癌肝转移（2例）、肺癌肝转移（2例）以及其他肿瘤肝转移（3例），2例患者有原发性肝肿瘤，分别为胆管细胞癌（1例）和胃泌素瘤（1例）。共对20个肿瘤（中位大小16mm）进行了17次治疗。评估技术成功率、安全性、局部肿瘤进展情况和总生存率。安全性根据介入放射学会的临床实践指南进行评估。
所有治疗程序均成功完成。无严重并发症发生。自限性气胸（1例）、呕吐（1例）和发热（1例）的B级并发症各出现1次。2个肿瘤出现局部肿瘤进展（局部肿瘤进展率为10%，2/20）。1年、3年和5年的局部肿瘤进展率分别为5%、11%。肿瘤大小超过20mm（P = 0.0003）和与主要血管接触（P = 0.03）是局部肿瘤进展的显著危险因素。对这些患者采用重复射频消融联合使用可降解淀粉微球的经动脉化疗栓塞术进行治疗。在中位随访48个月（范围4 - 77个月）期间，5例患者死亡（33%，5/15）。1年、3年和5年的总生存率分别为100%、85%和57%。中位总生存时间为69个月。
使用可降解淀粉微球的射频消融联合经动脉化疗栓塞术治疗非肝细胞癌性恶性肝肿瘤安全，且局部控制效果良好。
