Combined therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation for small hepatocellular carcinoma

Abstract

AIM:To assess the efficacy of combined transcatheter arterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT) for small hepatocellular carcinoma (HCC). METHODS:Thirty-five patients with a total of 41 HCC nodules (≤ 3 cm in diameter) were treated with TACE followed by computed tomograghy (CT)-guided percutaneous microwave coagulation therapy (PMCT) within 1-3 wk. RESULTS:By biopsies and enhanced CT scans, complete necrosis of the tumor and 3-5 mm of the surrounding non-cancerous area were observed in 34 foci. In seven foci, incomplete necrosis of the surrounding parenchyma was observed. Serum alphafetoprotein (AFP) levels returned to normal 10 d after treatment in 25 patients who originally had high serum AFP levels. The follow-up period was 6-31 mo, and all patients remained alive. One patient had a recurrence in the subsegments of the liver, and another patient had a recurrence near the original lesion. CONCLUSION:Combined therapy with TACE and PMCT is a safe and effective treatment without severe complications for small HCC.

Microwave Ablation Treatment of Liver Cancer with a 2,450-MHz Cooled-shaft Antenna: Pilot Study on Safety and Efficacy

“…Besides treating liver cancers, clinical application has been expanded to the treatment of neoplasms in other sites (Hadjicostas et al, 2006;Dib et al, 2009;Imoto et al, 2009;Pua et al, 2009;Rasekhi et al, 2009) Microwave, though less adopted at present, is a promising new modality for tumor ablation. In the past, microwave ablation was only performed in the Far East Liang et al, 2003;Liang et al, 2005;Yang et al, 2009). Encouraging therapeutic results have been obtained both for primary and metastatic liver cancers Liang et al, 2003;Liang et al, 2005;Yang et al, 2009).…”

“…In the past, microwave ablation was only performed in the Far East Liang et al, 2003;Liang et al, 2005;Yang et al, 2009). Encouraging therapeutic results have been obtained both for primary and metastatic liver cancers Liang et al, 2003;Liang et al, 2005;Yang et al, 2009). As the potential benefits of microwave became more apparent, western investigators also began to do experimental and clinical researches recent years (Wright et al, 2003;Wright et al, 2005;Hines-Peralta et al, 2006;Hines-Peralta et al, 2009).…”

Hepatocellular carcinoma: computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of large (5–7 cm) and very large (>7 cm) tumours

“…Even if some authors report smaller series of successful thermal ablation of HCC up to 7 cm in diameter, a diameter of 3-4 cm is usually accepted as the upper size limit for thermal ablation in the liver [19,20]. Other authors reported an improved complete ablation rate in thermal ablation of large HCCs after previous (chemo-)embolisation of hypervascularised HCC, resulting in a reduced heat sink effect [21,22]. According to the treatment plan of the Barcelona Liver Cancer Clinic (BCLC), lesions larger than 3 cm in diameter are intermediate or advanced stage HCCs and should be treated by transarterial chemoembolisation (TACE), systemic chemotherapy (sorafenib) or included into randomised control trials [23].…”

Study on the effect of chemoembolization combined with microwave ablation for the treatment of hepatocellular carcinoma in rats

“…Compared with single treatment regimen, the combination therapy yielded improved results regarding complete necrosis rate, tumor growth reduction, and overall survival (8,9,18). Combined therapy might have a synergistic effect for the following reasons: microwaves produce thermal energy through dielectric heating of water molecules in the affected tissue.…”