目的:微波消融(MWA)和常规经动脉化疗栓塞(cTACE)是通常在早期进行的局部治疗,早期和中期的肝细胞癌(HCC)。尽管结合局部方法在获得完全肿瘤坏死方面显示出令人鼓舞的结果,它们在单个会话中的应用描述不佳。我们的目的是评估单次MWA和cTACE治疗5-cmHCC的安全性和有效性及其对肝功能的影响。
方法:回顾性记录和分析2020年1月至2022年12月在我们的介入放射科接受MWA和cTACE单次治疗的所有5-cm肝癌。排除治疗前后影像学差或缺失的患者。技术上的成功,临床成功,并将并发症发生率作为主要终点.还评估了治疗前和治疗后的肝功能实验室参数。
结果:共15个病灶(平均病灶直径,5.0±1.4cm),15例患者(11例男性;平均年龄,67.1±8.9年)进行回顾性评估。技术和临床成功率分别为100%和73%,分别。记录了4例(27%)部分反应的病例,没有进展或稳定的病例。已发现AST和ALT值在治疗后实验室测试中显著较高。没有记录治疗前和治疗后实验室值之间的其他显着差异。AST和ALT治疗前后较高的差异(ΔAST和ΔALT)与较低的临床成功率显着相关。
结论:MWA和cTACE单次治疗对5-cm肝癌是安全有效的,无明显肝功能损害。治疗后AST和ALT值的增加可能是临床失败的预测因子。
OBJECTIVE: Microwave ablation (MWA) and conventional transarterial chemoembolization (cTACE) are locoregional treatments commonly performed in very early, early and intermediate stages of hepatocellular carcinoma (HCC). Despite combined locoregional approaches have shown encouraging results in obtaining complete tumor necrosis, their application in a single session is poorly described. Our aim was to evaluate the safety and efficacy of single-session MWA and cTACE treatment in 5-cm HCCs and its influence on liver function.
METHODS: All 5-cm HCCs treated by MWA and cTACE performed in a single-session in our Interventional Radiology unit between January 2020 and December 2022 were retrospectively recorded and analyzed. Patients with poor or missing pre- and post-treatment imaging were excluded. Technical success, clinical success, and complications rate were examined as primary endpoints. Pre- and post-treatment liver function laboratory parameters were also evaluated.
RESULTS: A total of 15 lesions (mean lesion diameter, 5.0 ± 1.4 cm) in 15 patients (11 men; mean age, 67.1 ± 8.9 years) were retrospectively evaluated. Technical and clinical success were 100% and 73%, respectively. Four (27%) cases of partial response and no cases of progressive or stable disease were recorded. AST and ALT values have found to be significantly higher in post-treatment laboratory tests. No other significant differences between pre- and post-treatment laboratory values were registered. AST and ALT pre- and post-treatment higher differences (ΔAST and ΔALT) were significantly associated with a lower clinical success rate.
CONCLUSIONS: MWA and cTACE single-session approach is safe and effective for 5-cm HCCs, without significant liver function impairment. A post-treatment increase in AST and ALT values may be a predictor for clinical failure.