经皮集束电极射频消融治疗小肝癌

目的 探讨经皮集束电极射频消融(radiofrequency ablation,RFA)对小肝癌(直径≤3cm)的治疗效果。方法利用RF-2000TM肿瘤射频治疗系统,在B超引导下对21例小肝癌患者24个肿块进行经皮肝穿刺射频热凝治疗,并用B超及CT检查以了解RFA治疗效果,随访观察其复发和生存情况。结果 RFA治疗后100％(20/20)的肿块血供消失(另4个治疗前即无血供),且2,4个肿块呈完全凝固性坏死(100％)。随访6月-3年,21侧中存活19例,半年生存率100％。存活的19例中,已有5例生存半年,4例生存1年,6例生存2年,4例生存3年。结论 集束电极RFA治疗小肝癌创伤小,安全,疗效可靠。     

经皮集束电极射频消融治疗小肝癌

目的探讨经皮案束电极射频消融(radiofrequency ablation，RFA)对小肝癌(直径≤3cm)的治疗效果。方法 利用RF-2000^TM肿瘤射频治疗系统，在B超引导下对21例小肝癌患24个肿块进行经皮肝穿刺射频热凝治疗，并用B超及CT检查以了解RFA治疗效果，随访观察其复发和生存情况。结果 RFA治疗后100％(20／20)的肿块血供消失(另4个治疗前即无血供)，且24个肿块呈完全凝固性坏死(100％)。随访6月-3年，21例中存活19例，半年生存丰100％。存活的19例中，已有5例生存半年，4例生存1年，6例生存2年，4例生存3年。结论案束电极RFA治疗小肝癌创伤小，安全，疗效可靠。     

经皮射频消融治疗肝癌

经皮射频消融治疗肝癌是当今最新的介入导向治疗方法之一，具有微创、安全、并发症少、近期疗效确定等特点，广泛用于治疗各种原发性及继发性肝癌。本文就该技术的适应证和禁忌证、术前准备、技术概况、实验与临床研究、随访观察、并发症及展望做一综述。     

经皮射频消融术与根治性切除术在小肝癌治疗中的疗效研究

目的探讨经皮射频消融术(RFA)治疗小肝癌的效果。方法将经影像学、病理学检查证实的小肝癌患者116例分为两组,分别行RFA和手术切除治疗,比较两组术后并发症的发生、术后1年两组肿瘤复发率及1、2、3年生存率。结果 RFA治疗组并发症发生率明显低于手术组,两组术后1年肿瘤复发率及1、2、3年生存率无统计学差异。结论对于小肝癌,肝功能不能耐受手术治疗或肿瘤实质位于靠近主要血管、胆管,切除困难的患者,RFA治疗具有与手术相同的效果,且并发症少。     

超声引导经皮射频消融治疗肝癌的探讨

目的 探讨超声引导在经皮穿刺射频消融技术治疗肝癌中的可行性与安全性。方法 应用超声对36例肝癌患进行穿刺引导，并实时检测射频消融的全过程。结果 36例患均在超声引导下顺利完成治疗，仅有1例术后肝包膜下出现小血肿。结论 准确的超声引导射频治疗肝癌术对提高疗效，减少并发症具有重要意义。     

经皮射频消融治疗巨大肝癌

目的总结冷循环射频消融(RFA)治疗巨大肝癌的临床疗效和经验。方法采用CT引导下经皮穿刺冷循环RFA治疗巨大肝癌24例,每个病灶进行射频消融1～4次,其中22例患者结合1～6次TACE治疗,术后通过增强CT或MR评价疗效,所有病例随访12～37个月。结果10例病灶完全坏死,余14例病灶大部分坏死,1年生存率83%,中位生存时间20个月,13例患者现仍存活。结论CT引导下经皮穿刺冷循环RFA治疗巨大肝癌安全、有效。     

异丙酚辅助射频消融治疗肝癌的临床研究

目的：探讨应用异丙酚作镇静麻醉辅助经皮肝穿刺射频消融（PRFA）治疗肝脏肿瘤的可行性，评价其效果和安全性。方法：将27例行PRFA治疗的肝癌病人辅以异丙酚静脉麻醉，记录患者体温、脉搏、呼吸、血压、氧饱和度、治疗时间及不良反应等。以25例未用异丙酚的PRFA患者作为对照组。结果：本组治疗中与治疗前比较，体温升高，脉搏及呼吸频率在治疗5min时最快（P〈0．01），其余时段虽有增快但无统计学意义；收缩压与舒张压在治疗5min时升高，其余时段降低，无统计学意义；血氧饱和度在静注异丙酚5、25min时呈下降趋势（P〈0．01）。异丙酚组患者的疼痛、大汗及恶心／呕吐显著低于对照组（P〈0．01-〈0．05），未发生明显不良反应。结论：应用异丙酚麻醉辅助PRFA，可明显减轻病人的痛苦，提高PRFA治疗的依从性和彻底性。     

经皮射频消融治疗肝癌

经皮射频消融治疗肝癌是当今最新的介入导向治疗方法之一,具有微创、安全、并发症少、近期疗效确定等特点,广泛用于治疗各种原发性及继发性肝癌.本文就该技术的适应证和禁忌证、术前准备、技术概况、实验与临床研究、随访观察、并发症及展望做一综述.     

经皮射频消融治疗膈下肝癌

目的评价CT引导下冷循环射频消融治疗膈下肝癌的可行性和疗效。方法20例肝癌患者共25个膈下病灶在CT引导下行冷循环射频消融治疗,术后复查增强CT或增强MR,观察病灶坏死情况。结果18个病灶完全坏死,病灶完全坏死率72%,其余7个病灶大部分坏死,无严重并发症。结论CT引导下冷循环射频消融术治疗膈下肝癌安全、有效。     

射频消融治疗肝癌的进展

在肝癌的局部治疗中,射频消融(radiofrequency ablation,RFA)是近年来兴起的一种新的治疗方法。尤其对于一些小肝癌的治疗,效果良好。其具有操作简便、创伤小、疗程短等优点。笔者现就其进展作一综述。     

Comparison of Radiofrequency Ablation and Hepatic Resection for the Treatment of Hepatocellular Carcinoma 2 cm or Less

Purpose

To compare survival outcome of radiofrequency (RF) ablation and surgical resection (SR) for treatment of hepatocellular carcinoma (HCC) ≤ 2 cm.

Liver Resection versus Radiofrequency Ablation plus Transcatheter Arterial Chemoembolization in Cirrhotic Patients with Solitary Large Hepatocellular Carcinoma

Purpose

To compare liver resection (LR) with single-step, balloon-occluded radiofrequency (RF) ablation plus drug-eluting embolics transarterial chemoembolization in cirrhotic patients with single hepatocellular carcinoma (HCC) ≥ 3 cm.

Conventional Chemoembolization Plus Radiofrequency Ablation versus Surgical Resection for Single,Medium-Sized Hepatocellular Carcinoma: Propensity-Score Matching Analysis

Purpose

To retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3–5-cm hepatocellular carcinoma (HCC).

Contrast-enhanced US-guided Radiofrequency Ablation of Hepatocellular Carcinoma

PurposeContrast-enhanced ultrasound (US) has been shown to be an efficient imaging modality in guiding radiofrequency (RF) ablation of hepatocellular carcinomas (HCC). The purpose of the present study was to assess the usefulness of contrast-enhanced US in guiding RF ablation in patients with early-stage HCC that was not clearly visible on grayscale US or noncontrast computed tomography (CT).Materials and MethodsDuring a 17-month period, contrast-enhanced US–guided RF ablation was performed in 14 patients with 19 early-stage lesions that were poorly defined on grayscale US and noncontrast CT. Contrast-enhanced US was repeated after 30 minutes, and complete ablation was defined as absence of any arterial-phase enhancement within the ablated lesion. Patients were followed periodically with clinical evaluation, liver function tests, α-fetoprotein measurement, and multiphasic CT or magnetic resonance (MR) imaging for a minimum of 1 year after ablation to look for local recurrence or disease progression. Survival probability was estimated with the Kaplan–Meier method.ResultsComplete tumor ablation was achieved in all 19 lesions, with no evidence of residual or recurrent tumor in the ablated areas after a mean follow-up of 16 months. No major complications were observed in any patient. However, new lesions developed in other parts of the liver on follow-up scans in three patients, and were accordingly treated with RF ablation. Two patients died of disease progression or liver failure within the 1-year follow-up.ConclusionsFor early-stage HCCs not well visualized on unenhanced US or CT, contrast-enhanced US provides an additional tool to guide RF ablation.     

CT引导下经皮肺穿刺射频治疗结肠直肠癌肺转移瘤

目的探讨在CT引导下经皮肺穿刺多电极高温射频RF-2000治疗结肠直肠癌肺转移瘤的临床效果和安全性方法对11例26个结肠直肠癌肺转移瘤进行多电极高温射频治疗,观察(1)无创血压、脉搏和周围血氧饱和度的变化;(2)治疗后肝肾功能、肺功能的变化;(3)治疗后CT扫描肿瘤组织低密度影和肿瘤体积的变化;(4)5年生存率的观察结果(1)治疗中血压、脉搏和周围血氧饱和度无明显改变;(2)治疗后肝肾功能、肺功能无明显改变;(3)治疗后1个月内肿瘤体积增大,治疗后3个月肿瘤体积通过CT扫描显示在26个肿瘤中23个完全消失(100%衰退),2个消退80%以上,1个消退50%～80%;肿瘤内低密度影3个月Ⅰ型1个,Ⅱ型3个,Ⅲ型22个;(4)5年生存率为81.82%(9/11)结论多电极高温射频仪RF-2000治疗结肠直肠癌肺转移瘤效果好、创伤小,具有良好的发展前景     

Combined Ethanol Injection Therapy and Radiofrequency Ablation Therapy in Percutaneous Treatment of Hepatocellular Carcinoma Larger than 4 cm

Background Optimal treatment of large-sized hepatocellular carcinoma (HCC) is still debated, because percutaneous ablation therapies alone do not always achieve complete necrosis. Objective To report our experience in the treatment of patients with HCC larger than 4 cm in diameter by combined percutaneous ethanol injection and radiofrequency thermal ablation. Methods In a 5-year period there were 40 consecutive patients meeting the inclusion criteria (24 men and 16 women; age range 41–72 years, mean 58 years). These subjects had a single HCC larger than 4 cm. Twelve subjects also had one or two additional nodules smaller than 4 cm (mean 1.2 nodules per patient). Patients were submitted to one to three sessions consisting of ethanol injection at two opposite tumor poles (mean 12 ml) and then of radiofrequency application through one or two electrodes placed at the tumor center (mean treatment duration 30 min). Results Complete necrosis was obtained in all cases with one to three sessions (mean 1.3 sessions per patient). All patients experienced pain and fever but one only subject had a major complication requiring treatment (abscess development and fistulization). Overall follow-up was 7–69 months. Two patients showed local recurrence and 9 developed new etherotopic HCC nodules. Seven subjects died during follow-up while 33 were free from recurrence 8–69 months after treatment. Conclusion A combination of ethanol injection and radiofrequency ablation is effective in the treatment of large HCC.     

Thermal Ablation versus Surgical Resection for the Treatment of Stage T1 Hepatocellular Carcinoma in the Surveillance,Epidemiology, and End Results Database Population

Purpose

To compare survival outcomes of small solitary hepatocellular carcinomas (HCCs) treated with thermal ablation vs resection in the Surveillance, Epidemiology, and End Results (SEER) cohort.

Chemoembolization Combined with Radiofrequency Ablation for Medium-Sized Hepatocellular Carcinoma: A Propensity-Score Analysis

PurposeTo compare survival outcomes of patients with single medium-sized hepatocellular carcinomas (HCCs) who underwent treatment with transarterial chemoembolization, radiofrequency (RF) ablation, or a combination of the 2 therapies.Materials and MethodsBetween 2000 and 2016, 538 patients underwent combined chemoembolization and RF ablation (n = 109), chemoembolization alone (n = 314), or RF ablation alone (n = 115) as first-line treatment for a single medium-sized (3.1–5.0 cm) HCC. Baseline demographic data (age, sex, etiology, Eastern Cooperative Oncology Group performance status, presence of liver cirrhosis, and serum bilirubin, albumin, and α-fetoprotein levels) were similar among groups except for Child–Pugh class, albumin level, and tumor size. Propensity-score analysis with inverse probability weighting (IPW) was used to reduce any bias in treatment selection and other potential confounding factors.ResultsMedian follow-up time was 46.2 months. Before IPW, overall survival (OS) durations were significantly different among the 3 groups (median, 85 months for combined therapy, 56.5 months for chemoembolization alone, and 52.1 months for RF ablation alone; P = .01). The 10-year OS rates were 40.1%, 25.5%, and 19.5% for the combined, chemoembolization-only, and RF ablation–only groups, respectively. After IPW, OS remained superior in the combined chemoembolization/RF ablation group compared with the monotherapy groups (10-y OS, 41.8% with combined therapy, 28.4% with chemoembolization alone, and 11.9% with RF ablation alone; P = .022).ConclusionsChemoembolization plus RF ablation may provide better survival outcomes than chemoembolization or RF ablation monotherapy, and can be considered a viable alternative treatment for unresectable single medium-sized HCCs.