title: Clinical application of transcatheter arterial chemoembolization combined with synchronous C-arm cone-beam CT guided radiofrequency ablation in treatment of large hepatocellular carcinoma.
abstract: OBJECTIVE
  This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC).
  
  
  METHODS
  21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate.
  
  
  RESULTS
  The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P < 0. 05). During 2 to 28 months of follow- up, in 19 cases with complete response, the average time without disease recurrence was 10.8 ± 6 months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively.
  
  
  CONCLUSIONS
  TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.
authors.affiliation: Department of Interventional Radiology, PLA General Hospital, Beijing, China. maoqiangwang@yeah.net
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Mao-Qiang
authors.initials: MQ
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Duan
authors.forename: Peng
authors.initials: P
authors.lastname: Song
authors.forename: Feng-Yong
authors.initials: FY
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Jie-Yu
authors.initials: JY
authors.lastname: Yan
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.forename: Kai
authors.initials: K
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D054893:Cone-Beam Computed Tomography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D015996:Survival Rate