Therapeutic effects and prognostic factors in high-intensity focused ultrasound combined with chemoembolisation for larger hepatocellular carcinoma

• Published in: European journal of cancer (1990) Vol. 46; no. 13; pp. 2513 - 2521
• Main Authors: Li, Chuanxing, Zhang, Weidong, Zhang, Rong, Zhang, Liang, Wu, Peihong, Zhang, Fujun
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.09.2010; Elsevier
• Subjects: Ablation; Adult; Aged; Biological and medical sciences; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic - methods; Classification; Combined Modality Therapy; Disease-Free Survival; Female; Hematology, Oncology and Palliative Medicine; Hepatocellular carcinoma; High-intensity focused ultrasound; High-Intensity Focused Ultrasound Ablation - methods; Humans; Kaplan-Meier Estimate; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prognostic factors; Prospective Studies; Transcatheter arterial chemoembolisation; Treatment Outcome; Tumor Burden; Tumors; Hepatocellular carcinoma; Transcatheter arterial chemoembolisation; Ablation; Prognostic factors; High-intensity focused ultrasound; Prognosis; High intensity focused ultrasound; Ultrasonic treatment; Instrumentation therapy; Hepatic disease; Malignant tumor; Artery; Liver cancer; Cancerology; Blood vessel; Digestive diseases; Circulatory system; Cancer; Chemoembolization
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2010.06.015

Abstract The purpose of this study is to evaluate high-intensity focused ultrasound (HIFU) ablation combined with transcatheter arterial chemoembolisation (TACE) in the treatment of larger hepatocellular carcinoma (HCC). Eighty-nine (89) patients with unrespectable larger HCC were randomised into a TACE group ( n = 45) and a TACE plus HIFU group ( n = 44). Therapeutic effects were assessed at follow-up with physical examination, level of serum α-fetoprotein and computed tomography or magnetic resonance imaging. All patients were followed up to observe long-term therapeutic effects and evaluated prognostic factors for survival. No severe complication was observed. Follow-up images showed that total effective rate in tumour response accounted for 72.8% in the TACE–HIFU group, which were significantly higher than that of TACE group (44.5%, P < 0.05). The 1-, 2-, 3- and 5-year overall survival rates for the TACE–HIFU group were 72.7%, 50.0%, 31.8% and 11.4%, respectively; correspondingly, for the TACE group were 47.2%, 16.7%, 2.8% and 0%, respectively ( P < 0.01). The 1-, 2-, 3- and 5-year disease-free survival rates for the TACE–HIFU group were 34.1%, 18.2%, 9.1% and 0%, respectively; correspondingly, for the TACE group were 13.9%, 5.6%, 0% and 0%, respectively ( P < 0.01). TNM stage, portal vein tumour thrombosis and Child-Pugh classification each had a significant effect on the survival. HIFU ablation combined with TACE is safe, effective and a promising approach for the treatment of larger HCC.