Efficacy and safety of combination therapy of chemoembolization and radiofrequency ablation with different time intervals for hepatocellular carcinoma patients

Surg Oncol. 2017 Sep;26(3):236-241. doi: 10.1016/j.suronc.2017.04.006. Epub 2017 May 3.

Abstract

Background and objectives: Combination of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) has become an effective alternative therapy for hepatocellular carcinoma (HCC). In clinical practice, the choice of time interval between TACE and RFA is a key point for curative effect, but optimal time interval is uncertain in guidelines. We aim to explore the optimal time interval for HCC patients of Child-Pugh classification A or B.

Methods: Two hundred and thirty-three HCC patients of Child A or B who had undergone TACE and RFA were enrolled and divided into seven groups according to different time intervals (1-7weeks). Tumor damage, liver function, complications and survival time of patients after treatment were analyzed.

Results: Complete remission rate and total effective rate decreased in groups with the prolonged time interval (p < 0.05). Average Child-Pugh score of patients in first three groups significantly increased one month after combination treatment (p < 0.01). While that not happened in other groups. Complications occurred in 16.7% patients, similarly occurred in groups (p > 0.1). Median survival time in groups four and five were 42 months, longer than other groups (p < 0.01).

Conclusion: A period of 3-5 weeks is the optimal time interval between TACE and RFA for HCC patients of Child-Pugh classification A or B.

Keywords: Child–Pugh score; Hepatocellular carcinoma; Radiofrequency ablation; Time interval; Transcatheter arterial chemoembolization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / therapy*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods*
  • Chemoembolization, Therapeutic / adverse effects
  • Chemoembolization, Therapeutic / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome