Abstract
RFA has been widely utilized in the treatment of small HCC (≤3 cm) with encouraging results. However, the limited volume of coagulative necrosis obtained with RFA systems and the occasionally irregular burn shape caused by the heat sink activity of the large vessels in the proximity of the ablated area have prevented the widespread use of RFA in the treatment of hepatic tumors. To obtain a large coagulation area, various techniques including transcatheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI), balloon occlusion of the hepatic artery and saline infusion during RFA, and so on have been used.
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References
Chen MS, Li JQ, Zheng YJ, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006;243:321–8.
Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003;362:1907–17.
Rossi S, Garbagnati F, Lencioni R, et al. Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply. Radiology. 2000;217:119–26.
Seki T, Tamai T, Nakagawa T, et al. Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma. Cancer. 2000;89:1245–51.
Shibata T, Isoda H, Hirokawa Y, et al. Small hepatocellular carcinoma: is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment? Radiology. 2009;252:905–13.
Morimoto M, Numata K, Kondou M, et al. Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization. Cancer. 2010;116:5452–60.
Peng ZW, Zhang YJ, Chen MS, et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol. 2013;31:426–32.
Yang W, Chen MH, Wang MQ, et al. Combination therapy of radiofrequency ablation and transarterial chemoembolization in recurrent hepatocellular carcinoma after hepatectomy compared with single treatment. Hepatol Res. 2009;39:231–40.
Shen SQ, Xiang JJ, Xiong CL, et al. Intraoperative radiofrequency thermal ablation combined with portal vein infusion chemotherapy and transarterial chemoembolization for unresectable HCC. Hepatogastroenterology. 2005;52:1403–7.
Yan S, Xu D, Sun B. Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: a meta-analysis. Dig Dis Sci. 2012;57:3026–31.
Wang W, Shi J, Xie WF. Transarterial chemoembolization in combination with percutaneous ablation therapy in unresectable hepatocellular carcinoma: a meta-analysis. Liver Int. 2010;30:741–9.
Schwartz M, Weintraub J. Combined transarterial chemoembolization and radiofrequency ablation for hepatocellular carcinoma. Nat Clin Pract Oncol. 2008;5:630–1.
Peng ZW, Zhang YJ, Chen MS, et al. Recurrent hepatocellular carcinoma treated with sequential transcatheter arterial chemoembolization and radiofrequency ablation versus radiofrequency ablation alone: a prospective randomized trial. Radiology. 2012;262:689–700.
Zhang YJ, Liang HH, Chen MS, et al. Hepatocellular carcinoma treated with radiofrequency ablation with or without ethanol injection: a prospective randomized trial. Radiology. 2007;244:599–607.
Cha DI, Lee MW, Rhim H, et al. Therapeutic efficacy and safety of percutaneous ethanol injection with or without combined radiofrequency ablation for hepatocellular carcinomas in high risk locations. Korean J Radiol. 2013;14:240–7.
Wong SN, Lin CJ, Lin CC, Chen WT, Cua IH, Lin SM. Combined percutaneous radiofrequency ablation and ethanol injection for hepatocellular carcinoma in high-risk locations. AJR Am J Roentgenol. 2008;190:W187–95.
Fisher RA, Maluf D, Cotterell AH, et al. Non-resective ablation therapy for hepatocellular carcinoma: effectiveness measured by intention-to-treat and dropout from liver transplant waiting list. Clin Transplant. 2004;18:502–12.
Mazzaferro V, Battiston C, Perrone S, et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg. 2004;240:900–9.
Latteri F, Sandonato L, Di Marco V, et al. Seeding after radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis: a prospective study. Dig Liver Dis. 2008;40:684–9.
Choi D, Lim HK, Joh JW, et al. Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas: long-term follow-up results and prognostic factors. Ann Surg Oncol. 2007;14:3510–8.
Taniai N, Yoshida H, Mamada Y, et al. Is intraoperative adjuvant therapy effective for satellite lesions in patients undergoing reduction surgery for advanced hepatocellular carcinoma? Hepatogastroenterology. 2006;53(68):258–61.
Choi D, Lim HK, Rhim H, et al. Percutaneous radiofrequency ablation for recurrent hepatocellular carcinoma after hepatectomy: long-term results and prognostic factors. Ann Surg Oncol. 2007;14:2319–29.
Liang HH, Chen MS, Peng ZW, et al. Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: a retrospective study. Ann Surg Oncol. 2008;15:3484–93.
Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378–90.
Xu M, Xie XH, Xie XY, et al. Sorafenib suppresses the rapid progress of hepatocellular carcinoma after insufficient radiofrequency ablation therapy: an experiment in vivo. Acta Radiol. 2013;54:199–204.
Mertens JC, Martin IV, Schmitt J, et al. Multikinase inhibitor sorafenib transiently promotes necrosis after radiofrequency ablation in rat liver but activates growth signals. Eur J Radiol. 2012;81:1601–6.
Li Y, Zheng YB, Zhao W, et al. Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma. Med Oncol. 2013;30:730.
Goldberg SN, Kamel JR, Kruskal JB, et al. Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy. Am J Roentgenol. 2002;179:93–101.
Wang JH, Tung HD, Chen TY, et al. Radiofrequency ablation of small hepatocellular carcinoma with intravenous pegylated liposomal doxorubicin. Hepatol Int. 2010;5:567–74.
Hong CW, Libutti SK, Wood BJ. Liposomal doxorubicin plus radiofrequency ablation for complete necrosis of a hepatocellular carcinoma. Curr Oncol. 2013;20:e274–7.
Ma HQ, Zhang YJ, Wang QJ, et al. Therapeutic safety and effects of adjuvant autologous RetroNectin activated killer cell immunotherapy for patients with primary hepatocellular carcinoma after radiofrequency ablation. Cancer Biol Ther. 2010;9:903–7.
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Peng, Z., Chen, M. (2016). Combined Therapies of RFA. In: Chen, M., Zhang, Y., Lau, W. (eds) Radiofrequency Ablation for Small Hepatocellular Carcinoma. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7258-7_8
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