Adwan Hamzah, Adwan Moath, Vogl Thomas J
Department of Diagnostic and Interventional Radiology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Cancers (Basel). 2023 Oct 20;15(20):5076. doi: 10.3390/cancers15205076.
A comparison of the combination therapy consisting of microwave ablation (MWA) after bland lipiodol-based transarterial embolization (TAE) with MWA alone in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria. Forty-nine patients in the TAE-MWA group (12 women and 37 men; mean age: 63.3 ± 9.6 years) with 55 tumors and 63 patients in the MWA group (18 women and 45 men; mean age: 65.9 ± 10.5 years) with 67 tumors were retrospectively enrolled in this study. For the investigation of treatment protocols based upon both safety and efficacy, patients' cases were analyzed with regard to complications, local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), and progression-free survival (PFS). There were no cases of major complications in either group. The LTP rate was 5.5% in the MWA-TAE group and 7.5% in the MWA group ( = 0.73). The rate of IDR was 42.9% in the MWA-TAE group and 52.4% in the MWA group ( = 0.42). The 12-, 24-, and 36-month OS rates starting at the date of tumor diagnosis were 97.7%, 85.1%, and 78.8% in the TAE-MWA group, and 91.9%, 71.4%, and 59.8% in the MWA group, respectively ( = 0.004). The 6-, 12-, and 24-month PFS rates were 76.5%, 55%, and 44.6% in the TAE-MWA group, and 74.6%, 49.2%, and 29.6% in the MWA group, respectively ( = 0.18). The combination therapy of TAE-MWA was significantly superior to MWA monotherapy according to OS in treating HCC within the Milan criteria.
在米兰标准范围内，对基于碘化油的单纯经动脉栓塞术（TAE）后行微波消融（MWA）的联合治疗与单纯MWA治疗肝细胞癌（HCC）进行比较。本研究回顾性纳入了TAE-MWA组的49例患者（12例女性和37例男性；平均年龄：63.3±9.6岁），共55个肿瘤，以及MWA组的63例患者（18例女性和45例男性；平均年龄：65.9±10.5岁），共67个肿瘤。为了基于安全性和有效性对治疗方案进行研究，分析了患者在并发症、局部肿瘤进展（LTP）、肝内远处复发（IDR）、总生存期（OS）和无进展生存期（PFS）方面的病例情况。两组均无严重并发症病例。TAE-MWA组的LTP率为5.5%，MWA组为7.5%（P = 0.73）。TAE-MWA组的IDR率为42.9%，MWA组为52.4%（P = 0.42）。从肿瘤诊断日期开始计算，TAE-MWA组的12个月、24个月和36个月OS率分别为97.7%、85.1%和78.8%，MWA组分别为91.9%、71.4%和59.8%（P = 0.004）。TAE-MWA组的6个月、12个月和24个月PFS率分别为76.5%、55%和44.6%，MWA组分别为74.6%、49.2%和29.6%（P = 0.18）。在米兰标准范围内治疗HCC时，根据OS，TAE-MWA联合治疗明显优于MWA单一治疗。
