Efficacy of transcatheter arterial chemoembolization alone or combined with microwave ablation in treatment of primary large liver cancer: a comparative analysis

Chang Peng; Zhang HongYi; Xiao Mei

doi:10.3969/j.issn.1001-5256.2015.06.013

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Jun. 2015

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Efficacy of transcatheter arterial chemoembolization alone or combined with microwave ablation in treatment of primary large liver cancer: a comparative analysis

DOI: 10.3969/j.issn.1001-5256.2015.06.013

Published Date: 2015-06-20

Abstract

Abstract

Objective To retrospectively analyze the short- term efficacy and long- term survival rates of transcatheter arterial chemoembolization( TACE) combined with percutaneous microwave coagulation therapy( PMCT) versus TACE monotherapy in the treatment of large primary hepatic carcinoma. Methods Sixty- seven patients with unresectable large primary hepatic carcinoma( > 5. 0 cm) who were admitted to our hospital from February 2011 to May 2014 were enrolled as subjects. Among these patients,34 patients received TACE monotherapy and 33 patients received TACE combined with PMCT. At one month after treatment,the abdomen was re- examined using contrast-enhanced computed tomography or magnetic resonance imaging,and liver function and alpha- fetoprotein( AFP) level were measured. The follow- up period varied from 3 to 36 months. Comparison of short- term outcomes,AFP level,and long- term survival rates were performed between the two groups. Comparison of continuous data was made by t test,and comparison of categorical data by χ2test and Fisher's test. Results The complete ablation rate and the response rate were significantly higher in the combination therapy group than in the TACE monotherapy group( 54. 5% vs 20. 6%,P = 0. 004; 97% vs 64. 7%,P = 0. 001). The AFP level after treatment with combination therapy was significantly lower than that before treatment with combination therapy and that after treatment with TACE monotherapy( P < 0. 001; P <0. 001). Patients in both groups had varying degrees of liver dysfunction and elevated aminotransferase,but with no severe complications such as bleeding,gastrostoma,colon fistula,bile duct injury,and needle tract metastasis,as well as deaths. The median survival time in the combination therapy group and the TACE monotherapy group was 13 months and 9 months,respectively,and the mean survival time was14. 00 ± 1. 63 months and 10. 83 ± 1. 19 months,respectively. The 1-,2-,and 3- year overall survival rates in the combination therapy group were significantly higher than those in the TACE monotherapy group( 63. 6% vs 28. 4%; 15. 2% vs 5. 9%; 4. 5% vs 0%; P =0. 044). Conclusion TACE combined with PMCT is a safe and effective therapy regimen,which achieves better treatment outcomes in local tumor control,substantially lower AFP level,and longer survival time than TACE monotherapy.
- carcinoma,hepatocellular,
- chemoembolization,therapeutic,
- microwave ablation

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References(28)

References

[1] JEMAL A,BRAY F,CENTER MM,et al.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.

[2]YANG PP,YE X.Research advances in microwave ablation and its clinical application[J].J Taishan Med Coll,2014,4(31):308-312.(in Chinese)杨平平,叶欣.微波消融技术及临床应用研究进展[J].泰山医学院学报,2014,4(31):308-312.

[3]FORNER A,LLOVET JM,BRUIX J.Hepatocellular carcinoma[J].Lancet,2012,379(9288):1245-1255.

[4]FAN J,WANG Z.New progress in multimodality therapy for primary liver cancer[J].Int J Dig Dis,2013,33(2):73-74,92.(in Chinese)樊嘉,王征.原发性肝癌综合治疗新进展[J].国际消化病杂志,2013,33(2):73-74,92.

[5]FERENCI P,FRIED M,LABRECQUE D,et al.Hepatocellular carcinoma(HCC):a global perspective[J].J Clin Gastroenterol,2010,44(4):239-245.

[6]SHU Y,WANG HY,TAO LM,et al.Curative effect of transcatheter hepatic arterial chemoembolization combined with microwave ablation for large liver cancer[J].Pract J Cancer,2014,29(8):996-998.(in Chinese)疏云,王洪云,陶黎明,等.经肝动脉化疗栓塞联合微波消融治疗大肝癌的疗效观察[J].实用癌症杂志,2014,29(8):996-998.

[7]XU LF,SUN HL,CHEN YT,et al.Large primary hepatocellular carcinoma:transarterial chemoembolization monotherapy versus combined transarterial chemoembolization-percutaneous microwave coagulation therapy[J].J Gastroenterol Hepatol,2013,28(3):456-463.

[8]LENCIONI R.Management of hepatocellular carcinoma with transarterial chemoembolization in the era of systemic targeted therapy[J].Crit Rev Oncol Hematol,2012,83(2):216-224.

[9]LLOVET JM,DI BISCEGLIE AM,BRUIX J,et al.Design and endpoints of clinical trials in hepatocellular carcinoma[J].J Natl Cancer Inst,2008,100(10):698-711.

[10]LENCIONI R,LLOVET JM.Modified RECIST(mRECIST)assessment for hepatocellular carcinoma[J].Semin Liver Dis,2010,30(1):52-60.

[11]IEZZI R,CESARIO V,SICILIANI L,et al.Single-step multimodal locoregional treatment for unresectable hepatocellular carcinoma:balloon-occluded percutaneous radiofrequency thermal ablation(BO-RFA)plus transcatheter arterial chemoembolization(TACE)[J].Radiol Med,2013,118(4):555-569.

[12]LIU HC,SHAN EB,ZHOU L,et al.Combination of percutaneous radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma:observation of clinical effects[J].Chin J Cancer Res,2014,26(4):471-477.

[13]QIN YJ,RU QS.Research progress in microwave ablation of liver cancer[J].Med Recapitulate,2012,18(17):2791-2794.(in Chinese)秦摇军,如清深.肝癌微波消融治疗的研究进展[J].医学综述,2012,18(17):2791-2794.

[14]SUN HT,ZHAO WW,CHEN ZM,et al.Clinical observation of microwave ablation combined with portal vein perfusion chemotherapy in the treatment of hepatocellular carcinoma combined with portal vein tumor thrombus[J].China Med Herald,2013,10(6):82-84.(in Chinese)孙厚坦,赵威武,陈朝旻,等.微波消融结合门静脉灌注治疗肝癌合并门静脉癌栓的临床观察[J].中国医药导报,2013,10(6):82-84.

[15]NI JY,LIU SS,XU LF,et al.Meta-analysis of radiofrequency ablation in combination with transarterial chemoembolization for hepatocellular carcinoma[J].World J Gastroenterol,2013,19(24):3872-3882.

[16]GERMANI G,PLEGUEZUELO M,GURUSAMY K,et al.Clinical outcomes of radiofrequency ablation,percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma:a meta-analysis[J].J Hepatol,2010,52(3):380-388.

[17]CHENG P,HE QW,LI D,et al.A retrospective study on TACE combined with PMCT in treatment of advanced liver cancer[J].Med J Natl Defending Forces Southwest China,2014,24(11):1194-1196.(in Chinese)程朋,何乾文,李东,等.TACE联合PMCT治疗中晚期肝癌的回顾性研究[J].西南国防医药,2014,24(11):1194-1196.

[18]GU L,LIU H,FAN L,et al.Treatment outcomes of transcatheter arterial chemoembolization combined with local ablative therapy versus monotherapy in hepatocellular carcinoma:a meta-analysis[J].J Cancer Res Clin Oncol,2014,140(2):199-210.

[19]WANG W,SHI J,XIE WF.Transarterial chemoembolization in combination with percutaneous ablation therapy in unresectable hepatocellular carcinoma:a meta-analysis[J].Liver Int,2010,30(5):741-749.

[20]PATEL M,SHARIFF MI,LADEP NG,et al.Hepatocellular carcinoma:diagnostics and screenin[J].J Eval Clin Pract,2012,18(2):335-342.

[21]MAILEY B,ARTINUYAN A,KHALILI J,et al.Evaluation of absolute serum alpha-fetoprotein levels in liver transplant for hepatocellular cancer[J].Arch Surg,2011,146(1):26-33.

[22]LEVI DM,TZAKIS AG,MARTIN P,et al.Liver transplant for hepatocellular carcinoma in the model for end-stage liver disease era[J].J Am Coll Surg,2010,210(5):727-734.

[23]CAO JH,ZHOU J,ZHANG XL,et al.Meta-analysis on radiofrequency ablation in combination with transarterial chemoembolization for the treatment of epatocellular carcinoma[J].Huazhong Univ Sci Technol Med Sci,2014,34(5):692-700.

[24]YIN XY,XIE XY,LU MD et al.Percutaneous thermal ablation of medium and large hepatocellular carcinoma:long-term outcome and prognostic factors[J].Cancer,2009,115(9):1914-1923.

[25]LIU C,LIANG P,LIU FY,et al.MWA Combined with TACE as a combined therapy for unresectable large-sized hepotocellular carcinoma[J].Int J Hyperthermia,2011,27(7):654-662.

[26]SONG YR,XU YQ.Application of AFP and hepatitis B makers in the diagnosis of liver cancer[J].J Pract Med Tech,2011,18(2):178-179.(in Chinese)宋延荣,徐勇全.甲胎蛋白与乙型肝炎标志物在肝癌诊断中的应用[J].实用医技杂志,2011,18(2):178-179.

[27]MIYAYAMA S,MATSUI O,ZEN Y,et al.Portal blood supply to locally progressed hepatocellular carcinoma after transcatheter arterial chemoembolization:observation on CT during arterial portography[J].Hepatol Res,2011,41(9):853-866.

[28]YU GZ,LIAO ZJ,QIU FK,et al.Clinical research on the cold-cycle microwave ablation in combination with TACE in the treatment of primary hepatocarcinoma[J].J Mod Oncol,2013,21(6):1306-1309.(in Chinese)余国政,廖子君,邱发凯,等.冷循环微波消融联合TACE治疗原发性肝癌的临床研究[J].现代肿瘤医学,2013,21(6):1306-1309.

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Efficacy of transcatheter arterial chemoembolization alone or combined with microwave ablation in treatment of primary large liver cancer: a comparative analysis

DOI: 10.3969/j.issn.1001-5256.2015.06.013