Microwave coagulation therapy for hepatic tumors: Review of the literature and critical analysis
Microwave coagulation therapy for hepatic tumors: Review of the literature and critical analysis
复制标题
肝肿瘤的微波凝固疗法： 文献回顾与批判性分析
DOI：
10.1016/j.suronc.2009.02.001
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发表时间：
2010-03-01
影响因子：
2.3
通讯作者：
Espat, N. J.
中科院分区：
文献类型：
--
作者：
Boutros, C.;Somasundar, P.;Espat, N. J.
背景资料：已证实手术切除恶性肝肿瘤可提高总生存率;然而，大多数患者不适合切除。对于无法切除的肿瘤患者，已经开发了各种化学和热消融方式。微波凝固治疗（MCT）是一个这样的热消融方式，本次审查的目的是评估目前可用的数据MCT和评估的证据水平，以支持其临床use.Methods：本次审查是有限的英文文献中发表的研究，包括至少30例患者的研究与MCT肝细胞癌（HCC）或结直肠肝转移（CRHM）。局部复发的模式，并发症和MCT消融术的生存结果进行了介绍和讨论，包括使用2.4 GHZ设备的亚洲经验和使用914 MHZ设备的美国经验的评估。尽管缺乏比较RFA和MCT用于肝脏消融的随机对照试验，我们的综述（基于2级数据）支持MCT在目标为较大坏死区和/或消融多处病变时可能是最佳选择。数据支持CRHM和HCC > 3 cm消融术的潜在手术优势不支持HCC < 3 cm;此外，MCT与所有其他消融方式一样，HCC局部复发率较高;可能是由于该疾病过程的多中心性。(c)2009爱思唯尔有限公司保留所有权利。
Background: Surgical resection of malignant hepatic tumors has been demonstrated to increase overall survival; however, the majority of patients are not candidates for resection. For patients with unresectable tumors, various chemical and thermal ablation modalities havebeen developed. microwave coagulation therapy (MCT) is one such thermal ablation modality and the purpose of this review is to evaluate the presently available data for MCT and assess the level of evidence to support its clinical use.Methods: This review is limited to published studies in the English literature including at least 30 patients per study with MCT for hepatocellular cancer (HCC) or colorectal hepatic metastasis (CRHM). Patterns of local recurrence, complications and survival outcome of MCT ablation are presented and discussed including assessment of Asian experience using the 2.4 GHZ deviceand American experience using the 914 MHZ device.Conclusions: Although randomized controlled trials comparing RFA and MCT for hepatic ablation are lacking, our review (based on level 2 data) supports that MCT may be optimal when larger necrosis zones and/or ablation of multiple lesions are the objectives. The data support that the potential procedural advantage(s) noted for ablation of CRHM and HCC > 3 cm, is not supported for HCC < 3 cm; moreover MCT shares with all other ablation modalities a high rate of locoregional recurrence in HCC; likely due to the multicentricity of this disease process.(c) 2009 Elsevier Ltd. All rights reserved.