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Background and purpose: Radiofrequency ablation (RFA) is one of the effective treatment methods for primary liver cancer and metastatic liver cancer. The purpose of this study was to investigate the risk factors of residual tumor after RFA for hepatic malignancies. Methods:A total number of 302 hepatic malignancies cases with 691 tumors after ultrasound-guided RFA from Jan. 2010 to Mar. 2013 were retrospectively analyzed. Single factor and multi-factor Logistic regression model were used to analyze the risk factors of residual tumor after RFA. Results:Complete ablation cases were 90.07%(272/302) for patients and 91.46%(632/691) for tumors, and the ablation residual rate was 8.54%. Ablation residual rates for tumor ≤3 cm, 3-5 cm and >5 cm in diameter were 6.30%, 9.57% and 28.57%, for tumor close to the intrahepatic vascular and gallbladder were 17.14%and 18.52%, for with and without combination with other local treatments were 7.02%and 13.41%, respectively. Multivariate analysis showed that tumor size>5 cm (P=0.044), proximity to large vessel (P=0.039) and without combination with other local treatments (P=0.001) were independent risk factors for ablation residual. Multivariate analysis showed that tumor near the intrahepatic vascular (P=0.014), single needle RFA (P=0.047) and without combination with other local treatments (P=0.023) were independent ablation residua risk factors for tumors between 3-5 cm in maximum diameter. Conclusion:Ultrasound-guided RFA can achieve satisfactory ablation effect. Tumor close to the intrahepatic vascular, tumor diameter>5 cm and without combination with other local treatment act as the independent risk factors for ablation residual. For tumors between 3-5 cm in diameter, in addition to close to intrahepatic blood vessels and without combination with other local treatment, single needle RFA is also another independent risk factor for ablation residual, and double-needle or multi-needle treatment can improve the ablation efifciency and reduce residual rate.
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Objective To evaluate the clinical efficacy of Qingrehuashi herbal formula combined with high intensity focused ul-trasound(HIFU ) in the treatment of advanced pancreatic cancer .Methods 86 patients with pancreatic cancer (22 case of III stage and 64 case of IV stage) were included in this study .18 cases were performed the HIFU therapy for 2-3 times .Other 68 cases re-ceived once HIFU therapy ,among 53 cases of liver metastasis ,8 cases were simultaneously conducted HIFU ablation therapy on liv-er metastasis .The patients were given Chinese medicines dominated by Qingrehuashi before and after HIFU therapy and during fol-low up period .Results The single evaluation on HIFU irradiation cases after 1 month:complete remision(CR) in 0 case ,partial re-mission(PR) in 8 cases(9 .3% ) ,stable disease(SD in 64 cases(74 .4% ) and progress disease(PD) in 14 cases(16 .3% ) .The median survival rate of 1 year and half a year was 52 .0% and 11 .4% .Among 73 cases of increased CA199 before treatment ,CA199 after treatment was decreased in 12 cases .Among 36 cases of increased CA242 before treatment ,CA242 after treatment was decreased in 15 cases .The effective rate of analgesic relief in all the cases was 70 .9% (62/86) .Conclusion The integrated therapy of Qingre-huashi herbal formula and HIFU is an effective method for treating advanced pancreatic cancer .
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Objective To evaluate the analgesic efficacy and effect of high intensity focused ultrasound (HIFU) in the treatment of advanced pancreatic cancer.Methods128 patients with pancreatic cancer ( Ⅲ stage 41 case,Ⅳ stage 87 case) were treated by HIFU.According to some parameters,such as the clinical symptoms,imaging examinations and survival analysis to assess the efficacy of HIFU treatment.Results22.9％ patients’ serum Ca19-9 decreased.The cancer pain was relieved in 72.5％ patients.Coagulated-necrosis by CT/MRI examination was observed.PR,SD and PD of all were 11.7％,70.3％ and 18.0％ respectively.1-year survival rate was 16.7％ for all patients,and median survival time was 7.0 months.1-year survival rate and median survival time for Ⅲ stage group were 28.5％ and 9.0 months,that of 10.8％ and 6.0 months for Ⅳ stage group respectively.ConclusionHIFU may benefit to advanced pancreatic cancer patient by stabilizing tumors,relieving pain and prolonging life expectancy with less side effects.
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<p><b>OBJECTIVE</b>To observe the long-term effects of combined transcatheter arterial chemoembolization (TACE) and radiotherapy for patients with large hepatocellular carcinoma (HCC) and to analyze the prognostic factors.</p><p><b>METHODS</b>A total of 107 patients with large unresectable HCC (the largest diameter of tumor ranged from 5 to 18 cm) were treated with TACE followed by external-beam irradiation. Acute effects and survival rates were observed. The Cox proportional hazards model was used to analyze the prognostic factors.</p><p><b>RESULTS</b>An objective response was achieved in 48.6% of the cases. The cumulative survival rates at 1, 3, and 5 years were 59.4%, 28.4%, and 15.8%, respectively. The tumor number and irradiation dose were the independent prognostic factors. The cumulative survival rates of the patients with a solitary lesion (75.8%, 43.9%, and 26.8% at 1, 3, and 5 years, respectively) were significantly higher than those with multiple lesions (31.3%, and 5.0% at 1 and 3 years, respectively, P=0.0005). The survival rates of the patients received irradiation above 40 Gy (95.8%, 74.7%, and 37.4% at 1, 3, and 5 years, respectively) were significantly higher than those received 20~40 Gy (60.9%, 20.7%, and 10.3%, respectively) and those received radiation lower than 20 Gy (26.7%, 7.1%, and 7.1%, respectively, P=0.0001).</p><p><b>CONCLUSIONS</b>Combined TACE with radiotherapy is a promising treatment for large unresectable HCC. The number of tumor is the most important clinical prognostic factor. Delivering the highest irradiation dose within the tolerance of the liver is the key to improve the long-term effect.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Diagnosis , Mortality , Radiotherapy , Therapeutics , Embolization, Therapeutic , Liver Neoplasms , Diagnosis , Mortality , Radiotherapy , Therapeutics , Prognosis , Survival RateABSTRACT
Purpose:To determine the effect of serum expression VEGF in TACE of hepatocellular carcinoma. Methods:We examined tumor blood vessels of 30 patients with HCC by angiography and measured serum VEGF concentrations by ELISA.Results:We found serum VEGF concentrations in hypervascular patients were higher than in hypovascular patients (8.80?3.23 ng/ml vs 5.70?2.68 ng/ml, P
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Objective To observe the clinical curative effect of transcatheter hepatic arterial chemoembolization (TACE) in treatment of gastrointestinal stromal tumors(GIST) with metastatic liver cancer. Methods Four GIST patients with 19 lesions of liver metastasis were treated with 2 ～ 4 times of TACE. The diameters of the metastatic tumor were from 2 ～ 5 cm. FuDR, CDDP, EPI-ADM, together with lipiodol ultrafluid and gelatin sponge to from a mirture was prepared for arterial embolization. Results DSA showed abundant tumor vasculature and tumor stain on hepatoarterial angiography. The size of tumor showed no decrease after TACE and lipiodol was cleared away in a short period. No patient achieved CR or PR until two of them received imatinib. Conclusions TACE is not effective in treating hepatic metastasis from GIST shown in limited cases. (J Intervent Radiol, 2006, 15: 283-285)