Endpoint of embolization: A study of transarterial chemoembolization in patients with large hepatocellular carcinoma.

PURPOSE: To explore the degree of embolization and embolization endpoints in patients with large hepatocellular carcinoma (HCC) treated via transarterial chemoembolization (TACE). METHODS: Thirty-two HCC patients treated with TACE from 2015 to 2016 who met the enrollment criteria for this study were retrospectively analyzed. The experimental group was treated via complete embolization, with complete occlusion of the tumor blood supplying artery, while the control group underwent incomplete embolization of any blood supplying arteries, with limited residual visible blood flow detectable via angiography. Postoperative liver and kidney function, complications, prognosis, and survival for patients in these two groups were analyzed. RESULTS: There was no significant difference at baseline patient condition between the two treatment groups before treatment. After treatment, the alanine aminotransferase (ALT), aspartic aminotransferase (AST), and white blood cell (WBC) values in the experimental group were significantly higher than those in the control group (p=0.031, 0.038, and 0.034, respectively). There was also a significant increase in hepatic aseptic necrosis and acute liver function damage in the experimental group relative to the control group (p=0.015 and 0.023, respectively). Compared with the control group, the prognosis and survival of the experimental group was significantly decreased. Univariate and multivariate Cox regression analyses of overall survival revealed that the different treatment group and hepatitis B infection status were the main factors affecting patient prognosis and survival. CONCLUSIONS: For patients with large HCC tumors with a limited number of supporting arteries, careful attention should be paid to the use of embolic agents during the TACE procedure. Rather than proceeding to complete embolization of the artery root, embolization can be terminated when the main tumor feeding artery is still faintly visible on an angiogram in a structure reminiscent of a tree with dry branches, thereby reducing adverse outcomes in patients.

Analgesia of percutaneous thermal ablation plus cementoplasty for cancer bone metastases.

BACKGROUND: The purpose of this study was to review recent research related to the analgesic effect of ablation therapy combined with cementoplasty, as well as to identify the duration of analgesic effect and risk for cement leaks. METHODS: A systematic literature search using PubMed, Web of Science, and annual meeting proceedings of the oncology society and other organizations were conducted. RESULTS: Twelve retrospective studies met the inclusion criteria. Four of the studies included in the review assessed the changes immediately after treatment. Five studies were subjected to analyses of analgesic effect of combined percutaneous thermal ablation and Cementoplasty at 24 weeks after treatment. Incidences of leakage of bone cement during surgery were detected in 4 out of 12 studies. The change of mean pain scores at 1 days, at 1 week, and at 4 weeks, 12 weeks, and 24 weeks after treatment were -3.90 (95% CI: -4.80 to -3.00), -4.55 (95% CI:-5.46 to -3.64), -4.78 (95% CI: -5.70 to -3.86), -5.16 (95% CI: -6.39 to -3.92), and -5.91 (95% CI: -6.63 to -5.19). The relative risk of cement leakage was 0.10 (95% CI: -6.63 to -5.19). CONCLUSIONS: Our systematic review suggested that thermal ablation combined with cementoplasty could be a safe and effective intervention for the management of bone metastases-induced pain.

Efficacy of radiofrequency ablation and microwave ablation in the treatment of thoracic cancer: A systematic review and meta-analysis.

BACKGROUND: Radiofrequency ablation and microwave ablation are frequently prescribed for thoracic cancer. However, few writers have been able to draw on any systematic research into the differences between the two ablation methods. METHODS: A literature search was carried out using Embase, PUBMED, Web of Science, Cochrane Library, and CNKI databases, with additional searches carried out manually using terms associated with thoracic cancer and thermal ablation. Then we used Google Scholar for a complementary search. Data were extracted from studies of patients that underwent radiofrequency ablation or microwave ablation, and the investigator carried out efficacy evaluation and follow up. The data obtained from the literature were summarized and analyzed using Cochrane Revman software Version 5.3 and SPSS 22.0. RESULTS: There were seven comparative studies, but no randomized studies identified for data extraction; 246 patients received radiofrequency ablation therapy and 319 controls received microwave ablation. There was no significant difference in the six-month, one-year, two-year, and three-year survival rates, and adverse reactions were found in the two treatments. For patients' long-term survival rate, the two treatments can achieve a similar survival time. CONCLUSION: In the treatment of thoracic cancer, microwave ablation can achieve the same efficacy as radiofrequency ablation.