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題 名 | Monopolar Radiofrequency Ablation for Medium-sized Hepatocellular Carcinoma: Preliminary Experience with Single-Electrode Overlapping Ablation and Multiple-Electrode Switching System=經皮單極射頻消融術於治療中型肝細胞癌:單針重疊消融與多針切換系統的經驗 |
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作 者 | 王勝永; 王蒼恩; 林慶忠; 劉家源; 王鴻源; 林俊昌; 洪猶崇; 蔡樹榮; 陳志仁; 趙文綺; 吳肇卿; 施壽全; | 書刊名 | 臺灣癌症醫學雜誌 |
卷 期 | 2:1 2015.03[民104.03] |
頁 次 | 頁12-21 |
分類號 | 416.246 |
關鍵詞 | 單極射頻消融; 單針重疊消融; 多針切換系統; 熱消融; Monopolar RFA; Overlapping ablations; Switching system; Thermoablation; |
語 文 | 英文(English) |
中文摘要 | 背景:射頻消融術在治療早期小型肝細胞癌俱有相當好的療效。動物實驗發現多針電極切換系統能夠產生較傳統單針電極或集束電極系統消融更大的體積。最近有些研究使用多針電極射頻消融術證實能達到局部控制中型肝細胞癌。本研究的目的在評估單極射頻消融術使用單針重疊消融或多針切換系統治療 3至 5公分大小的中型肝細胞癌的治療成效。方法:本研究共收入 20位中型肝細胞癌的患者。 9位患者(6位男性與 3位女性)接受單針重疊單極射頻消融術。 11位患者(4位男性與 7位女性)接受單針單極多針切換系統射頻消融術。本研究收入的患者中,有 12位(60%)患者在接受治療時肝細胞癌為多發結節。多針切換系統治療患者的腫瘤大小(4.6 ± 0.3公分)較單針重疊消融(3.6 ± 0.6公分)為大。接受治療一個月後以電腦斷層或核磁共振評估治療成效。本研究評估患者接受射頻消融術後之治療成效、局部腫瘤復發、總和存活。結果:總和來說, 18位(90%)中型肝細胞癌患者接受射頻消融術後一個月評估達到腫瘤完全消融。細分來說,8位患者(88.9%)接受單針重疊單極射頻消融術達完全消融,10位患者(90.9%)接受單針單極多針切換系統射頻消融術達完全消融。接受單針重疊單極射頻消融術患者之平均追蹤時間為 14.9個月(總範圍 2至 26個月),而接受單極多針切換系統射頻消融術為 20.2個月(總範圍 4至 41個月)。在 18位達到腫瘤完全消融的患者, 2位患者 (一位接受單針重疊消融,另一位接受多針切換系統消融)在追蹤期間有局部腫瘤復發。結論:中型肝細胞癌可以有效地使用單極射頻消融術治療,在本中期追蹤研究中顯示,不論是使用單針重疊消融或是多針切換系統消融皆能夠達到類似的腫瘤完全消融率、局部腫瘤復發率、與總和存活率。多針切換系統治療較大的中型肝細胞癌與單針重疊術式消融較小的中型肝細胞癌的治療效果相當。 |
英文摘要 | Background: Radiofrequency ablation (RFA) has been regarded as an effective treatment for early and small hepatocellular carcinoma (HCC). In vivo porcine studies showed a multiple-electrode switching system could create larger necrotic areas than single-electrode or cluster-electrode ablations. Some recent studies demonstrated a multiple-electrode RFA system could achieve local control of medium-sized HCCs. This study aimed to evaluate the treatment results of monopolar RFA with either single-electrode overlapping ablations or a multiple-electrode switching system in treating medium-sized (3-5 cm) HCC. Methods: A total of 20 patients with medium-sized hepatocellular carcinomas were included in this study. Nine patients (6 males and 3 females) were treated with single- electrode mono-polar RFA. Eleven patients (4 males and 7 females) were treated with multiple- electrode switching monopolar RFA. Twelve patients (60%) included in this study had multi- nodular HCCs at the time of treatment. The tumor size was slightly larger in the multiple- electrode group (4.6 ± 0.3 cm) compared to that in the single-electrode group (3.6 ± 0.6 cm). CT or MR imaging studies were performed at 1 month after RFA to evaluate treatment effectiveness. Thereafter, local tumor progression, treatment effectiveness and survival after RFA were evaluated. Results: Overall, 18 of 20 patients (90%) showed satisfactory ablation of HCCs 1 month after their RFA procedures. Treatment effectiveness was achieved in 8 patients (88.9%) with single- electrode overlapping ablation and 10 (90.9%) patients with multiple-electrode switching system. The mean follow-up periods were 14.9 (range, 2-26) months in the single-electrode group, and 20.2 (range 4-41) months in the multiple-electrode group. Among the 18 patients who achieved primary tumor control, 2 patients (1 in the single-electrode group and 1 in the multiple-electrode group) had local progression noted during follow-up examinations. Conclusions: Medium-sized hepatocellular carcinoma can be effectively ablated with mono-polar radiofrequency ablation by either single-electrode overlapping ablation or a multiple- electrode switching system. Regarding mid-term treatment responses, both RFA approaches can achieve similar treatment effectiveness, local tumor progression rate, and survival probabilities. Multiple-electrode switching RFA can treat larger medium-sized HCC with comparable mid-term efficacy as smaller medium-sized HCC treated with single-electrode overlapping RFA. |
本系統中英文摘要資訊取自各篇刊載內容。