Radiofrequency ablation of small hepatocellular carcinoma with intravenous pegylated liposomal doxorubicin

Abstract

Purpose Synergy between radiofrequency ablation (RFA) and chemotherapy was demonstrated for liver malignancy. We assess the efficacy of intravenous pegylated liposomal doxorubicin (PLD) for RFA in patients with small hepatocellular carcinoma (HCC). Methods This study was designed as a non-randomized control trial. Patients received either PLD (20 mg) intravenously before RFA, or standard RFA alone. Computed tomography was performed immediately and 4 weeks after RFA to obtain ablative diameter, area and volume for each tumor. The changes in ablation size were analyzed by paired images for each tumor. All patients were followed up regularly. Results A total of 24 patients with 29 HCCs, including 12 patients with 16 tumors (mean 2.2 cm ± 0.9) in the PLD and RFA group, and 12 patients with 13 tumors (2.4 cm ± 0.5) in the RFA alone group, were enrolled. The ablative diameter, area and volume significantly decreased 4 weeks after RFA. The ablative volume decrease was significantly greater for the RFA alone group than for the combination group (26.1 vs. 12.1%, p = 0.018). The 3-year cumulative tumor progression and survival rates did not differ significantly between the two groups. Conclusion Intravenous PLD before RFA reduced contraction of ablative volume and might have no impact on tumor progression and survival in patients with small HCC after RFA.

Role of Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: Experience of a Cancer Center in China

“…RFA-PEI offered a significant survival advantage over RFA alone for patients with tumors 3.1–5 cm in diameter but not for those with tumors equal to or less than 3.0 cm in diameter or for those with tumors 5.1–7 cm in diameter. Moreover, some reports have suggested that RFA combined with injection of cytotoxic drugs improves the efficacy, although this remains to be proved [30]. Combination of different locoregional therapies is a simple, easy way to improve prognosis.…”