Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma.
BACKGROUND
A small number of microwave electrode insertions and microwave irradiations were used to obtain complete tumor necrosis in hepatocellular carcinomas (HCC) measuring > 2.0 cm but </= 3.0 cm in greatest dimension. The efficacy of combining transcatheter arterial chemoembolization (TACE) with subsequent percutaneous microwave coagulation therapy (PMCT) was assessed in this study.


METHODS
Eighteen patients with cirrhosis and HCCs measuring > 2.0 cm but </= 3.0 cm in greatest dimension underwent TACE followed within 1-2 days by ultrasonographically guided PMCT.


RESULTS
On dynamic computed tomography, 17 of the 18 patients showed complete necrosis of their tumor lesions and the treated tumor margins (>/= 5 mm). Necroses of tumors and noncancerous margins surrounding the tumors were obtained using 4 microwave irradiations (1 session) in 14 patients, 5 microwave irradiations (2 sessions) in 2 patients, and 6 microwave irradiations (2 sessions) in 1 patient. The follow-up period was short (12-31 mos), and all patients remained alive. No local recurrences in the treated areas were detected. No fatal complications were observed. Pleural effusion was observed in 1 patient only.


CONCLUSIONS
This combined therapy of PMCT applied within 1-2 days of TACE effectively treated HCCs measuring > 2.0 cm but </= 3.0 cm in greatest dimension. A small number of microwave electrode insertions and microwave irradiations were used.
Seki
T
T
The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan. sekit@takii.kmu.ac.jp
Tamai
T
T
Nakagawa
T
T
Imamura
M
M
Nishimura
A
A
Yamashiki
N
N
Ikeda
K
K
Inoue
K
K
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000201:enzymology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000097:blood / Q000201:enzymology / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011379:Prognosis; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase