Radiofrequency Ablation of Intrahepatic Cholangiocarcinoma: Preliminary Experience
Radiofrequency Ablation of Intrahepatic Cholangiocarcinoma: Preliminary Experience
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DOI：
10.1007/s00270-010-9849-3
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发表时间：
2010-08-01
影响因子：
2.9
通讯作者：
Fugazzola, Carlo
中科院分区：
文献类型：
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作者：
Carrafiello, Gianpaolo;Lagana, Domenico;Fugazzola, Carlo
本研究的目的是在一个小的、非随机的系列研究中评估经皮超声（US）引导下射频消融（RFA）治疗肝内胆管癌（ICCA）患者的安全性和有效性。2004年2月至2008年7月，6例ICCA患者（4男2女，平均年龄69.8岁[48 ~ 83岁]）行经皮超声引导下RFA。2例行介入前经动脉栓塞以减少RFA期间的热分散，以增加消融面积。治疗后1个月及以后每3个月采用对比增强动态计算机断层扫描（CT）评估RFA的疗效。对6例患者的6个实体性肝肿瘤进行了9次射频消融治疗。随访时间13 ~ 21个月（平均17.5个月）。术后CT显示1 - 2次RFA治疗后6个肿瘤中有4个完全坏死。2例肿瘤较大（直径5 cm和5.8 cm）可见残留肿瘤。所有患者均能耐受手术，且无重大并发症。只有1例患者出现rfa后综合征（疼痛、发热、不适和白细胞增多），经口服对乙酰氨基酚解决。经皮射频消融术是一种安全有效的治疗肝脏肿瘤的方法，非常适合那些不适合手术的患者。关于局部和全身复发和生存的长期随访数据仍然需要。
The purpose of this study was to evaluate the safety and efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) in patients with intrahepatic cholangiocarcinoma (ICCA) in a small, nonrandomized series. From February 2004 to July 2008, six patients (four men and two women; mean age 69.8 years [range 48 to 83]) with ICCA underwent percutaneous US-guided RFA. Preintervetional transarterial embolization was performed in two cases to decrease heat dispersion during RFA in order to increase the area of ablation. The efficacy of RFA was evaluated using contrast-enhanced dynamic computed tomography (CT) 1 month after treatment and then every 3 months thereafter. Nine RFA sessions were performed for six solid hepatic tumors in six patients. The duration of follow-up ranged from 13 to 21 months (mean 17.5). Posttreatment CT showed total necrosis in four of six tumors after one or two RFA sessions. Residual tumor was observed in two patients with larger tumors (5 and 5.8 cm in diameter). All patients tolerated the procedure, and there with no major complications. Only 1 patient developed post-RFA syndrome (pain, fever, malaise, and leukocytosis), which resolved with oral administration of acetaminophen. Percutaneous RFA is a safe and effective treatment for patients with hepatic tumors: It is ideally suited for those who are not eligible for surgery. Long-term follow-up data regarding local and systemic recurrence and survival are still needed.