Combined radiofrequency ablation and drug-eluting beads TACE for large hepatocellular carcinoma

Congress:

ECR 2011

Poster Number:

C-0686

Type:

Scientific Paper

Keywords:

Interventional non-vascular, Oncology, Abdomen, Catheter arteriography, CT, Ultrasound, Ablation procedures, Chemoembolisation, Neoplasia, Cirrhosis

Authors:

F. Turini, I. Bargellini, A. Cicorelli, S. Mazzeo, E. Bozzi, S. Vannucci, R. Lencioni, R. Cioni, C. Bartolozzi; Pisa/IT

DOI:

10.1594/ecr2011/C-0686

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-0686

Fig. 1: CT examination before treatment, showing a large HCC lesion in the right liver...

Fig. 2: Fig 2 (same case Fig.1). Transarterial chemoembolization performed 24h after...

Fig. 3: Fig 3 (same case Fig.1). The angiographic study at the end of the procedure...

Fig. 4: (same case Fig.1) 1-month CT follow-up, showing a large necrotic area, without...

Fig. 5: (same case Fig.6) Transarterial chemoembolization performed 24h after RFA...

Purpose

To prospectively evaluate the efficacy of combined radiofrequency ablation (RFA) and doxorubicin-eluting beads transarterial chemoembolization (DEB-TACE) in a series of patients with single hepatocellular carcinoma (HCC) larger than 3 cm.

Methods and Materials

From September 2005 to January 2010, 34 patients (26 males, mean age 70 ± 7.7 years) with unresectable hepatocellular carcinoma, larger than 3 cm in maximum diameter (mean size 43.3 ± 15 mm, range 33-80mm) underwent RFA followed by DEB-TACE. Percutaneous RF ablation was performed with US guidance using a 250-W generator (RITA Medical Systems 1500X; AngioDynamics, Queensbury, NY) connected to a 15-G expandable multitined electrode (RITA Medical System StarBurst XL; AngioDynamics). All procedures were carried out under conscious sedation. DEB-TACE was performed the day...

Results

SAFETY The procedure was technically successful in all cases. No major complications were observed. Mild post-embolization syndrome was observed in 16 patients. No relevant deterioration of liver function was recorded. The mean hospital stay was 2.1 days ± 0.8 (2-4 days). TUMOR RESPONSE At 1-month imaging follow-up, complete tumor response (CR) was obtained in 26 target lesions (76.5%) (Figure 1-9) and partial response (PR) in 8 lesions (23.5%). CR was significantly (P=.004) higher in smaller lesions (Figure 10). At 6-months, CR rate was 66.7% (22/33...

Conclusion

In patients with unresectable HCC larger than 3cm, the combination of RFA and DEB-TACE is safe and results in a high rate of sustained complete tumor response.

References

Ahmed M, Liu Z, Lukyanov AN, et al. Combination radiofrequency ablation with intratumoral liposomal doxorubicin: effect on drug accumulation and coagulation in multiple tissues and tumor types in animals. Radiology 2005;235:469–477. Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology 2005;42:1208–1236. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 2001;35:421–430. Choi D, Lim HK, Rhim H, K et al. Percutaneous radiofrequency ablation for early-stage...