Laser thermal ablation in the treatment of small hepatocellular carcinoma: Results in 74 patients
Laser thermal ablation in the treatment of small hepatocellular carcinoma: Results in 74 patients
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DOI：
10.1148/radiol.2213001501
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发表时间：
2001-12-01
期刊：
影响因子：
19.7
通讯作者：
Rossi, Z
中科院分区：
文献类型：
--
作者：
Pacella, CM;Bizzarri, G;Rossi, Z
目的：评价激光热消融(LTA)治疗小肝癌的安全性、局部有效性和远期疗效。材料和方法：在门诊接受LTA治疗的74例患者中，92例活检证实为小肝癌(0.8~4.0 cm)。将功率为5.0W的激光与1~4根光纤耦合，穿过21号针(S)6~12分钟。用计算机断层扫描(CT)评估所有病变的大小和血管形态、复发率和累积存活率的变化。结果：117次LTA治疗中无重大并发症发生，平均每个肿瘤治疗1.3次。3个月后，CT扫描显示92个病灶中89个(97%)无强化(完全坏死)。在随访期间(范围6-66个月，平均25.3个月)，84个肿瘤(91%)缩小。术后1~5年局部复发率1.6%~6.0%。其他肝段的复发率(12-60个月)从24%到73%不等。无癌生存率(1~4年)为73%~24%。1年、3年和5年的总生存率分别为99%、68%和15%。死亡21例(28%)。结论：LTA是治疗小肝癌安全有效的方法。
PURPOSE: To evaluate the safety, local effectiveness, and long-term results of laser thermal ablation (LTA) in the treatment of small hepatocellular carcinoma (HCC).MATERIALS AND METHODS: Ninety-two biopsies proved small HCCs (range, 0.8-4.0 cm) in 74 patients who were treated percutaneously with LTA in an outpatient clinic. A laser at a power of 5.0 W was coupled with one to four fibers that were advanced through 21-gauge needle(s) for 6-12 minutes. All lesions were evaluated with computed tomography (CT) for changes in size and vascular pattern, recurrence rates, and cumulative survival rates. Patients were examined for complications.RESULTS: No major complications occurred in 117 LTA sessions, with an average of 1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing area (complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6-66 months; mean, 25.3 months), 84 tumors (91%) decreased in size. The local recurrence rates (range, 1-5 years) ranged from 1.6% to 6.0%. Recurrence rates (range, 12-60 months) in other liver segments ranged from 24% to 73%. Cancer-free survival rates (range, 1-4 years) ranged from 73% to 24%. Overall survival rates were 99%, 68%, and 15% at 1, 3, and 5 years, respectively. Twenty-one patients (28%) died.CONCLUSION: LTA is a safe and effective treatment for small HCC.