Efficacy of combination therapies of percutaneous or laparoscopic ethanol-lipiodol injection and radiofrequency ablation.
Efficacy of combination therapies of percutaneous or laparoscopic ethanol-lipiodol injection and radiofrequency ablation.
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DOI：
10.3892/ijo.25.6.1737
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发表时间：
2004-12
影响因子：
5.2
通讯作者：
K. Kurokohchi;T. Masaki;Y. Miyauchi;N. Hosomi;Hirohito Yoneyama;S. Yoshida;T. Himoto;Akihiro Deguchi;S. Nakai;Hideyuki Inoue;Seishiro Watanabe;S. Kuriyama
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文献类型：
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作者：
K. Kurokohchi;T. Masaki;Y. Miyauchi;N. Hosomi;Hirohito Yoneyama;S. Yoshida;T. Himoto;Akihiro Deguchi;S. Nakai;Hideyuki Inoue;Seishiro Watanabe;S. Kuriyama
经皮射频消融（RFA）能够在几个疗程内摧毁肝细胞癌（HCC），且无严重并发症。我们以前已经表明，不仅经皮乙醇注射和RFA（PEI RFA）的联合使用，而且乙醇和碘油的混合物（PELIT）注射是有用的治疗肝癌。在本研究中，我们进一步开发了通过经皮或腹腔镜途径（PELI-RFA或LELI-RFA）联合使用PELIT和RFA，并评估其有效性。18例19个结节行PELI-RFA或LELI-RFA治疗。在LELI-RFA治疗的病例中，没有观察到出血，也没有从消融的肿瘤表面溢出含有肿瘤细胞的乳白色液体。在用PELI-RFA或LELI-RFA充分治疗的病例中，乙醇和碘油的混合物在肿瘤的整个区域积聚，并且通过计算机断层扫描（CT）观察到碘油存款周围的低密度区域。这些凝固区域的描绘有助于评估PELI-RFA或LELI-RFA治疗肿瘤周围安全边界的精确区域。此外，凝固性坏死的总体积与消融所需能量和PELI-RFA或LELI-RFA注入的乙醇体积的乘积显著正相关。在接受PELI-RFA或LELI-RFA治疗的病例中，仅1例局部复发，PELI-RFA无法达到足够的安全边界。因此，评估RFA治疗是否可以获得足够的安全边界是至关重要的，PELI-RFA和LELI-RFA有助于可视化安全边界区域。
Percutaneous radiofrequency ablation (RFA) is able to destroy hepatocellular carcinoma (HCC) in a few sessions without major complications. We have previously shown that not only the combined use of percutaneous ethanol injection and RFA (PEI-RFA) but also injection of mixture of ethanol and lipiodol (PELIT) was useful for the treatment of HCC. In the present study, we further developed the combined use of PELIT and RFA through percutaneous or laparoscopic approach (PELI-RFA or LELI-RFA) and evaluated its usefulness. Nineteen nodules in 18 cases were treated with PELI-RFA or LELI-RFA. In the cases treated with LELI-RFA, no bleeding and no spilling milky fluid containing tumor cells were observed from the surface of ablated tumors. In the cases sufficiently treated with PELI-RFA or LELI-RFA, the mixture of ethanol and lipiodol was accumulated in the entire region of the tumor and low-density area was observed around the lipiodol deposit by computed tomography (CT). These delineations of coagulated area were helpful to evaluate the precise area of safety margin around the tumor treated with PELI-RFA or LELI-RFA. Furthermore, the total volume of coagulated necrosis significantly and positively correlated with the product of energy requirement for ablation and the volume of ethanol injected by PELI-RFA or LELI-RFA. Among the cases treated with PELI-RFA or LELI-RFA, local recurrence emerged only in one case in whom enough safety margin could not be achieved by PELI-RFA. Therefore, it is critical to evaluate whether enough safety margin could be obtained with RFA therapy, and PELI-RFA and LELI-RFA are helpful in visualizing the safety margin area.