Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer
Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer
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DOI：
10.2214/ajr.167.3.8751696
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发表时间：
1996-09-01
影响因子：
5
通讯作者：
Buscarini, L
中科院分区：
文献类型：
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作者：
Rossi, S;DiStasi, M;Buscarini, L
客观的。本研究的目的是评估射频间质热消融治疗肝癌的有效性。对象和方法。 50 名患者接受了射频间质热消融，其中 39 名患者有 41 个肝细胞癌结节，2 名患者有 13 个肝转移结节。除一种外，所有方法均产生大于肿瘤结节体积的热坏死体积，以获得肿瘤的完全破坏。对一个大肿瘤进行了减瘤治疗。 结果。平均 3.3 次射频间质热消融即可实现肝细胞癌结节的破坏。在平均 22.6 个月（范围 3-66 个月）的随访期间，39 名患者中有 16 名（41%）复发；其中 2 名 (5%) 患者出现局部复发，其余 14 名 (36%) 出现新病灶。这 16 名患者中的 9 名接受了进一步的射频间质热消融术，结果证明是有效的。射频间质热消融术也在四名第二次复发的患者中成功重复。通过射频间质热消融，我们治疗了 39 名患者的 54 个肝细胞癌结节。 39 名患者中有 11 名 (28%) 死亡：其中 5 名死于晚期癌症导致的肝功能衰竭，6 名死于癌症以外的原因。对三名死于癌症以外原因的患者进行了尸检，其中一名患者因两个新病灶接受了两个新疗程的射频间质热消融。肉眼检查未能发现两个已治疗的肿瘤结节；对其他三个治疗肿瘤结节的组织学检查显示两个结节完全坏死，另一个结节中有 3 毫米的活癌细胞灶。累积生存曲线显示中位生存时间为 44 个月。第一年的fdr生存率为0.94，第二年为0.86，第三年为0.68，第四年和第五年为0.40。在接受转移性结节治疗的患者中，治疗后影像学研究显示所有病例的坏死率从 80% 到 100% 不等。对两名接受射频间质热消融后接受手术的患者进行的病理研究显示，其中一名患者 100% 坏死，另一名患者 80% 坏死。结论。射频间质热消融是一种有用的经皮治疗肝癌的方法。
OBJECTIVE. The aim of this study was to evaluate the usefulness of RF interstitial thermal ablation for treating hepatic cancer.SUBJECTS AND METHODS. Fifty patients, 39 who had 41 hepatocellular carcinoma nodules and ii who had 13 hepatic metastatic nodules, underwent RF interstitial thermal ablation. In all but one, a thermal necrosis volume greater than the tumoral nodule volume was created to obtain total tumor destruction. One large tumor was treated for debulking purposes.RESULTS. Hepatocellular carcinoma nodule destruction was achieved in a mean of 3.3 sessions of RF interstitial thermal ablation. During a mean follow-up of 22.6 months (range, 3-66 months), 16 (41%) of 39 patients had recurrences; two (5%) of these patients showed local recurrences and the remaining 14 (36%) had new lesions. Nine of these 16 patients underwent further RF interstitial thermal ablation that proved effective. RF interstitial thermal ablation was also successfully repeated in four patients who had a second recurrence. With RF interstitial thermal ablation, we treated 54 hepatocellular carcinoma nodules in 39 patients. Eleven (28%) of the 39 patients died: five from hepatic failure due to advanced cancer and six from causes other than cancer. Autopsy was performed on three patients who died from causes other than cancer, one had had two new courses of RF interstitial thermal ablation for two new lesions. Gross examination failed to detect two treated tumor nodules; histologic examination of three other treated tumor nodules showed total necrosis in two nodules and a 3-mm focus of viable cancer cells in the other nodule. Cumulative survival curves showed the median survival time to be 44 months. The survival rate fdr the first year was 0.94, 0.86 for the second year, 0.68 for the third year, and 0.40 for the fourth and fifth years. In the patients treated for metastatic nodules, posttreatment imaging studies showed necrosis that varied from 80% to 100% in all cases. Pathologic studies performed on two patients who underwent surgery after RF interstitial thermal ablation showed 100% necrosis in one case and 80% necrosis in the other.CONCLUSION. RF interstitial thermal ablation is a useful percutaneous treatment for hepatic cancer.