Treatment of hepatocellular carcinoma with cool-tip radiofrequency ablation: evaluation of effectiveness and efficiency

• Main Authors: Yu-Sheng Lee, 李郁昇
• Other Authors: Chiung-Wen Kuo
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/a4423r

碩士 === 元培科技大學 === 醫學影像暨放射技術研究所 === 101 === Purpose: Hepatocellular carcinoma (HCC) is the most common cancer related disease, there is more than 500,000 new cases occur in the world. Radiofrequency ablation (RFA) is a widely used ablative technique for hepatocellular carcinoma. The aim of this study was to investigate the therapeutic efficacy of RFA on HCC and to identify the factors affecting the efficiency. Materials and Methods: Six hundred and seventy-seven patients (445 men, 232 women; mean aged 69 years) with 1423 HCCs (tumor size, 0.7 - 6.0 cm) were enrolled in this study. All RFA treatments were performed with a standard protocol by using a Cool-TipTM(Radionics, Burlington, MA, USA). The cure rate was evaluated by computed tomography (CT) and magnetic resonance imaging (MRI) after 1 month RFA treatment. The Kaplan-Meier analysis was performed to investigate the survival rate. The Pearson correlation analysis was used to determine the factors affected the cure rate. Results: A total of 1181 lesions were cure (82.9%) with 2.4% the complication rate whereas the death rate after RFA was 0.2%. The highest cure rate (83.8%) was occurred at tumor nodules under 3 cm, 3-5 cm tumor nodules intermediate (75.3%), and the lowest cure rate (70%) was observed at tumor nodules over 5 cm. The mean survival rate was 86.3% (104 cases of death) and the recurrence rate was 2.6% within 42.8 ± 23.6 months follow-up period. Our results demonstrated that survival rate at 1 year, 3 years, 5 years, 7 years was 94%, 86%, 81.7%, 75 %, respectively. In the correlation analysis, the therapeutic efficacy of RFA was positively correlated with lesion size (r = 0.078, p = 0.003), treatment temperature (r = 0.073, p = 0.006), and ablation time (r = 0.073, p = 0.006). Conclusion: RFA is an effective technique for the treatment of liver tumors, especially for small hepatocellular carcinoma. The treatment time, lesion location, treatment temperature, and lesion size could affect the cure rate.