Percutaneous cryoablation in combination with ethanol injection for unresectable hepatocellular carcinoma  

作　　者：Ke-Cheng Xu Li-Zhi Niu Wei-bin He Zi-Qian Guo Yi-Ze Hu Jian-Sheng Zuo Fuda Cancer Hospital of Guangzhou,Guangzhou 510300,Guangdong Province,China 

出　　处：《World Journal of Gastroenterology》2003年第12期2686-2689,共4页世界胃肠病学杂志（英文版）

摘　　要：AIM: To evaluate the effectiveness and safety of percutaneous hepatic cryoablation in combination with percutaneous ethanol injection (PEI) in patients with unresectable hepaocellular carcinoma (HCC).METHODS: A total of 105 masses in 65 HCC patients underwent percutaneous hepatic cryoablation. The cryoablation was performed with the Cryocare system (Endocare, Irvine, CA, USA) using argon gas as a cryogen.Two freeze-thaw cycles were performed, each reaching a temperature of -180 ℃ at the tip of the probe. PEI was given in 36 patients with tumor masses larger than 6 cm in diameter 1-2 weeks after cryoablation and then once per week for 4 to 6 sessions. The efficacy was evaluated with survival, change of tumor size and alpha-fetoprotein (AFP) levels. RESULTS: During a follow-up duration of 14 months in average with a range of 5 to 21 months, 33 patients (50.8 %)were free of tumors, 22 patients (33.8 %) alive with tumor recurrence: two had bone metastases, three were found to have lung metastases, and the remaining 17 recurrences occurred in the liver, of whom only 3 developed a cryosite recurrence. Among the 41 patients who were followed up for more than one year, 32(78 %) were alive despite of tumor recurrence. Seven patients (10.8 %) died due to disease recurrence. Three patients (4.6 %) died due to some noncancer-related causes. Among the 43 patients who had a CT scan available for review, 38 (88.4 %) had a shrinkage of tumor mass. Among the 22 patients who received biopsies of cryoablated tumor mass, all biopsies except one, showed only dead or scar tissues. Of the patients who had an increased AFP preablatively, 91.3 % had a decrease of AFP to normal or nearly normal levels during postablative 3-6 months. Complications of cryoablation included liver capsular cracking in one patient,transient thrombocytopenia in 4 patients and asymptomatic right-sided pleural effusions in 2 patients. Two patients developed liver abscess at the previous cryoablation site at 2 and 4 months, respectively,following cryoablation, aAIM:To evaluate the effectiveness and safety of percutaneous hepatic cryoablation in combination with percutaneous ethanol injection (PEI) in patients with unresectable hepaocellular carcinoma (HCC). METHODS:A total of 105 masses in 65 HCC patients underwent percutaneous hepatic cryoablation.The cryoablation was performed with the Cryocare system (Endocare,Irvine,CA,USA) using argon gas as a cryogen. Two freeze-thaw cycles were performed,each reaching a temperature of-180 ℃ at the tip of the probe.PEI was given in 36 patients with tumor masses larger than 6 cm in diameter 1-2 weeks after cryoablation and then once per week for 4 to 6 sessions.The efficacy was evaluated with survival,change of tumor size and alpha-fetoprotein (AFP) levels. RESULTS:During a follow-up duration of 14 months in average with a range of 5 to 21 months,33 patients (50.8 %) were free of tumors,22 patients (33.8 %) alive with tumor recurrence:two had bone metastases,three were found to have lung metastases,and the remaining 17 recurrences occurred in the liver,of whom only 3 developed a cryosite recurrence.Among the 41 patients who were followed up for more than one year,32(78 %) were alive despite of tumor recurrence.Seven patients (10.8 %) died due to disease recurrence.Three patients (4.6 %) died due to some noncancer-related causes.Among the 43 patients who had a CT scan available for review,38 (88.4 %) had a shrinkage of tumor mass.Among the 22 patients who received biopsies of cryoablated tumor mass,all biopsies except one,showed only dead or scar tissues.Of the patients who had an increased AFP preablatively,91.3 % had a decrease of AFP to normal or nearly normal levels during postablative 3-6 months.Complications of cryoablation included liver capsular cracking in one patient,transient thrombocytopenia in 4 patients and asymptomatic right-sided pleural effusions in 2 patients.Two patients developed liver abscess atthe previous cryoablation site at 2 and 4 months,respectively, following cryoablation,and was recovered after treated

关 键 词：经皮穿刺 乙醇 不可切除肝细胞癌 CT检查 生活质量 

分 类 号：R735.7[医药卫生—肿瘤]