ABSTRACT
Objective Toinvestigatetheshort-termefficacyoftranscatheterarterialchemoembolization(TACE)combinedwith microwaveablation (MWA;TACE-MWA)inthetreatmentofmultinodularhepatocellularcarcinoma (HCC).Methods 58patients withmultinodularHCCtreatedintheinterventionalmedicinecenterfromJanuary2015toJanuary2017wereincludedingradeAor B.34cases(groupA)receivedTACEand24cases(groupB)underwentTACE-MWAtherapy.Theshort-termefficacywasevaluatedbyfollow-upandanalysisofthetimetoprogression (TTP),localrecurrencerate,newlesionrate,andpostoperativecomplicationsinboth groups.Results TheTTPinthetwogroupswas38-240 (106.2±63.1)daysand90-630 (328.5±178.8)daysrespectively.The incidenceofpostoperativecomplicationsintwogroupswas2.9% (1/34)and4.2% (1/24)respectivelyI.ngroupA,thelocalrecurrenceratewas 52.9% (18/34)andthenewfocusratewas76% (26/34);inthegroupB,thelocalrecurrenceratewas8.3% (2/24)andthenewfocusratewas 66.7% (16/24).Thedifferenceoflocalrecurrenceratebetweenthetwogroupswasstatisticallysignificant(P<0.05),whiletheincidenceofnew lesionwasnotsignificantlydifferent (P>0.05).Conclusion TACE-MWAissafeandeffectiveinthetreatmentofmultinodular HCC.ComparingwithtraditionalTACEtreatment,TACE-MWAcansignificantlyimprovedTTPandlocalcontrolrate.
ABSTRACT
Objective ToevaluatetheefficacyandsafetyofCT-guidedmicrowaveablation (MWA)forstageIVlungcanceraccompanied withcontrolledsingleintracranialmetastasis.Methods From November2011toOctober2016,78patientsinourhospitaldiagnosed withstageIVnon-smallcelllungcanceraccompaniedwithcontrolledsingleintracranialmetastasiswerestudied.Patientsweredividedintotwo groupsaccordingtowhethertheywerewillingtoacceptlocalMWAtreatmentornot:thegeneralgroup (groupA)with42cases, and MWAgroup(groupB)with36cases.Aftertheintracranialmetastasiswascontrolled,patientsingroupAweretreatedwithGP regimenforsimplechemotherapy,whilepatientsingroupB weretreatedwithlocalMWAcombinedwithGPregimen(gemcitabine combinedwithcisplatin).Allthepatientswerefollowed-upevery3monthsafterthesurgerytoassesstheefficacyandsafetyofthe correspondingtreatment.Thedeadlineofthefollow-upwasJune2017orwhenthetumorrestarteditsdevelopment.Results Thesuccessrateof theMWAofthe39lesionsinthe36patientsingroupBwas100%.TheKaplan-Meiersurvivalanalysisofthefollow-updataofthe twogroupsshowedthattheaverageprogressionfreesurvival(PFS)ofgroupA was(9.9 ± 0.8)monthsandthemedianPFSwas (8.0±0.5)months,whilethePFSofgroupB was (14.1±1.1)monthsandthe medianPFS was (15.0±1.5)months.The Log Rank testshowedthatχ2=8.780andP=0.03<0.05,whichreflectedthatthereweresignificantdifferencesinsurvivaltimebetweenthe twogroups.Theoverallsurvival(OS)ofgroupA was(20.5±1.1)months,andthemedianOSwas(21.0±1.3)months.TheOSof group B was (24.1±1.5)months,andthe median OS was (25.0±3.6)months.The Log Rank testshowedthat χ2=10.57and P=0.02<0.05, whichprovedthattheOSdifferencesbetweenthetwogroupshadstatisticalsignificance.ThemainadverseeffectsofMWA werepain,pleural effusion,pneumothorax,hemoptysis,infectionandsoon.There werenoseriouslife-threateningcomplicationsingroupB.Conclusion LocalMWAtreatmentforstageⅣnon-smallcelllungcancer withcontrolledsingleintracranialmetastasisisasafeandeffective method.Itisworthyofporularizing.