Combined RF Ablation and Doxorubicin Eluting Bead Chemoembolisation in Hepatocellular Carcinoma

Abstract No:

125

Author:

R Lencioni, University of Pisa, Tuscany, Italy 
L Crocetti, C Vignali, P Petruzzi, E Bozzi, R Cioni, et al

Presented:

Society of Interventional Radiology (SIR), March 2007

Purpose:

To investigate feasibility, safety, and effectiveness of radiofrequency ablation (RFA) combined with doxorubicin eluting bead arterial embolisation in hepatocelluar carcinoma (HCC) treatment.

Materials & Methods:

Twenty patients with single HCC > 3cm showing evidence of residual viable tumour at CT or MR imaging obtained immediately after RFA will be enrolled (14 completed). The patient population includes 11 males and 3 females (63-80 years old; mean, 70 ± 5). Tumour sizes range from 3.5 7.0cm (mean, 5.1 ±1.2). RFA was performed by using expandable multitined electrodes (RITA Medical Systems). Arterial embolisation was performed 24 hours after RFA by using 50-125mg doxorubicin loaded in either 100-300 or 300-500µm beads (DC Bead). Treatment efficacy was evaluated by CT and MR at 1 month and at 3-month intervals during the follow-up (mean follow up, 5.3 months ± 3.3).

Results:

Treatment protocol was successfully completed in all patients. One patient developed hepatic infarction that did not require any treatment. The range of volumes of unenhancing tissue representing coagulation necroses increased from 15.4 – 128.9ccm (mean, 47.7 ± 37.2) after RFA alone to 16.8 – 171.7ccm (mean, 76.6 ± 53.9) after doxorubicin eluting bead arterial embolisation, with an increase of 5 – 134% (mean, 58.8% ± 42.4). The increase in unenhancing volume resulted in complete ablation of 9 (64.3% ) of 14 tumours.

Conclusion:

Preliminary data of this pilot clinical study show that arterial embolisation with doxorubicin eluting beads substantially increase the effect of RFA in the treatment of large HCC tumours.

 

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