Clinical Application of Transcatheter ArterialChemoembolization Combined with Synchronous C-armCone-Beam CT Guided Radiofrequency Ablation in treatmentof Large Hepatocellular Carcinoma

Abstract

<br /><strong>Objective</strong>: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterialchemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation(RFA) in treatment of large hepatocellular carcinoma (HCC). <br /><strong>Methods</strong>: 21 patients with large HCC were studiedfrom January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA wereperformed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFPdetection were regularly conducted to evaluate the technical success rate of combined treatment, complications,treatment response, time without disease recurrence and survival rate. <br /><strong>Results</strong>: The technical success rate ofcombined treatment was 100%, without any significant complication. After 1 month, there were 19 cases withcomplete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and aclinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) wassignificantly higher than that of multiple nodular lesions (50%, 2/4) (P < 0. 05). During 2 to 28 months of followup,in 19 cases with complete response, the average time without disease recurrence was 10.8 ± 6 months. Thetotal survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. <br /><strong>Conclusion</strong>: TACE combinedwith synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacyfor single nodular lesion is better than that for multiple nodular lesions.