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Efficacy and safety of combination therapy of chemoembolization and radiofrequency ablation with different time intervals for hepatocellular carcinoma patients
Authors:Yue-min Feng  Xing Wang  Le Wang  Xiao-wen Ma  Hao Wu  Hao-ran Bu  Xiao-yu Xie  Jian-ni Qi  Qiang Zhu
Affiliation:1. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China;2. Hospital Administration Office, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China;3. Shandong Provincial Engineering and Technological Research Center for Liver Diseases Prevention and Control, Jinan, Shandong Province, China
Abstract:

Background and objectives

Combination of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) has become an effective alternative therapy for hepatocellular carcinoma (HCC). In clinical practice, the choice of time interval between TACE and RFA is a key point for curative effect, but optimal time interval is uncertain in guidelines. We aim to explore the optimal time interval for HCC patients of Child-Pugh classification A or B.

Methods

Two hundred and thirty-three HCC patients of Child A or B who had undergone TACE and RFA were enrolled and divided into seven groups according to different time intervals (1–7weeks). Tumor damage, liver function, complications and survival time of patients after treatment were analyzed.

Results

Complete remission rate and total effective rate decreased in groups with the prolonged time interval (p < 0.05). Average Child-Pugh score of patients in first three groups significantly increased one month after combination treatment (p < 0.01). While that not happened in other groups. Complications occurred in 16.7% patients, similarly occurred in groups (p > 0.1). Median survival time in groups four and five were 42 months, longer than other groups (p < 0.01).

Conclusion

A period of 3–5 weeks is the optimal time interval between TACE and RFA for HCC patients of Child-Pugh classification A or B.
Keywords:Hepatocellular carcinoma  Transcatheter arterial chemoembolization  Radiofrequency ablation  Time interval  Child–Pugh score  TACE  transcatheter arterial chemoembolization  RFA  radiofrequency ablation  HCC  hepatocellular carcinoma  CRR  complete remission rate  TER  total effective rate  CPs  Child-Pugh score
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