Individualized treatment models based on blood supply characteristics in hepatocellular carcinoma using color Doppler hemodynamics.
OBJECTIVE
We evaluated the long-term efficacy of the combination of transcatheter arterial chemoembolization (TACE) using cisplatin-lipiodol suspension, transultrasonic portal vein chemoembolization (SPVE), radiofrequency ablation (RF), percutaneous ethanol injection (PEI) for treatment of advanced small hepatocellular carcinoma (HCC).


METHODS
A total of three hundred and eighteen patients with HCC were enrolled in this study. According to the blood supply characteristics to the tumor, individual combined therapy models were adopted: one hundred and fifty-nine patients with HCC less than 5 cm were treated with a combination of RF and PEI (RF/PEI group) and one hundred and one patients with HCC greater than 5cm were treated with a combination of TACE, RF and PEI (TACE/RF/PEI group). One hundred and eleven HCC nodules confirmed to be hypervascular by color Doppler flow imaging were treated with a combination of TACE, RF, SPVE and PEI (TACE/ RF/SPVE/PEI group).


RESULTS
The combination treatment of RF and PEI (RF/PEI group), the TACE/RF/PEI group, TACE/ RF/SPVE/PEI group, the 1-year survival rates and the 3-year survival rates were 97.3% and 82.4%; 73.5% and 44.9%; 74.1% and 37.9%, respectively; The vanishing rate of blood flow around and within the tumor, the tumor size decrease rate, AFP transformed to negative rate, were significantly raised compared to those in the TACE treatment only group.


CONCLUSIONS
The individual combined therapy models combination of TACE, PEI, SPVE, RF appears to prolong survival, compared with one treatment alone (TACE). This combination therapy method is an effective way for treating HCC, and color Doppler can provide important information to verify the therapeutic effects.
Si
Qin
Q
The 81st Hospital of People's Liberation Army of China, Nanjing, China.
Mu
HongYan
H
Yan
GuoZhen
G
Qian
XiaoLi
X
Xu
ChangZheng
C
Wang
Xuan
X
Tong
Wei
W
D001783:Blood Flow Velocity / Q000502:physiology; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D000431:Ethanol / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007261:Infusions, Intra-Arterial; D015552:Injections, Intralesional; D007459:Iodized Oil; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010166:Palliative Care; D011169:Portal Vein / Q000000981:diagnostic imaging; D012039:Regional Blood Flow / Q000502:physiology; D015996:Survival Rate; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
D000431:Ethanol; D007459:Iodized Oil; D002945:Cisplatin