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
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 after RFA to take advantage of the reactive hyperemia induced by RF application.
In fact,
marked periablational hypervascularity was observed during the angiographic study and the increase in arterial blood flow at that level facilitates the delivery of the microspheres (Figures 2).
After superselective catheterization of the segmental arterial branches feeding the tumour using 3F microcatheters,
a standard dose of 2 ml of 100-300 µm DEB (DC Bead; Biocompatibles,
Surrey,
UK) uploaded with 50 mg doxorubicin (Adriblastina; Farmitalia,
Milan,
Italy) were administered.
Additional amounts of either 100-300 or 300-500 µm DEB were used if needed,
to obtain complete embolization of feeding arteries.
The follow-up protocol included contrast-enhanced CT or MR studies performed 1 month after treatment and every 3-months thereafter.
Study endopoints:
Primary: safety
tumor response (according to amended RECIST criteria)
Secondary: time to tumor recurrence
time to radiological progression
survival