Clinical studies of laser ablation in treatment of primary liver carcinoma-associated portal vein tumor thrombus.
OBJECTIVE
To explore the clinical values of laser ablation as a new treatment for portal vein tumor thrombus (PVTT).


METHODS
A total of 43 male patients with primary liver carcinoma (PLC)-associated PVTT were randomized into a laser ablation group and a radiotherapy group. The laser ablation group of 21 cases received direct percutaneous laser ablation under ultrasonographic guide, followed by direct injection into the portal vein with chemotherapy drugs including mitomycin C (MMC) and fluorouracil (5-Fu). The radiotherapy group of 22 cases was treated with X-ray in three-dimensional conformal radiotherapy (3D CRT) once a day for a total of 10 days course. After the treatment, all patients were followed for postoperative adverse reactions, changes of tumor thrombus, and survival time.


RESULTS
In comparison with the radiotherapy, laser ablation resulted in decreased postoperative complications such as limb fatigue, ascites, upper gastrointestinal ulcer, and bleeding. The overall remission rates (complete remission [CR] + partial remission [PR]) were 61.9% (13/21) and 31.8% (7/22) in the laser ablation and radiotherapy group, respectively, with a significant difference (P < .05). All cases in the laser group showed clinical improvement and the average survival time prolonged to greater than 19.5 months (P < .002).


CONCLUSIONS
Percutaneous laser ablation to PVTT is an effective, safe, and simply procedure and has proven to offer significant clinical outcomes in the treatment of PLC-associated PVTT.
Sun
Baomu
B
Department of Integrated Chinese Traditional and Western Medicine, Eastern Hepatobiliary Surgical Hospital of Second Military Medical University, Shanghai, China.
Luo
Ming
M
Lu
Zhenghua
Z
Meng
Yan
Y
Wu
Shengbing
S
Wu
Mengchao
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D011788:Quality of Life; D020266:Radiotherapy, Conformal; D016019:Survival Analysis; D020246:Venous Thrombosis / Q000209:etiology* / Q000601:surgery*
D016685:Mitomycin; D005472:Fluorouracil