Treatment of liver cancer of middle and advanced stages using ultrasound-guided percutaneous ethanol injection combined with radiofrequency ablation: A clinical analysis

Sun,Xue; Li,Ru; Zhang,Botao; Yang,Yuejie; Cui,Zhifei

doi:10.3892/ol.2016.4180

Treatment of liver cancer of middle and advanced stages using ultrasound-guided percutaneous ethanol injection combined with radiofrequency ablation: A clinical analysis

Authors:
- Xue Sun
- Ru Li
- Botao Zhang
- Yuejie Yang
- Zhifei Cui
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Affiliations: Department of Medical Ultrasonics, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China, Department of Medical Ultrasonics, The Third Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China, Department of Medical Ultrasonics, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
Published online on: February 2, 2016 https://doi.org/10.3892/ol.2016.4180
Pages: 2096-2100
Copyright: © Sun et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Liver cancer is a malignancy of the digestive system and has a high morbidity and mortality rate. Local intervention has become a viable option in identifying liver treatment. The aim of the present study was to analyze the clinical effects of treating liver cancer in middle and advanced stages using ultrasound‑guided percutaneous ethanol injection (PEI) in tumors combined with radiofrequency ablation (RFA). A total of 100 patients with stage III-IV liver cancers were selected to participate in the study. Patients were divided into groups. In group A, treatment was initiated with PEI and after 1‑2 weeks RFA was applied while in group B treatment was initiated with RFA and after 1‑2 weeks PEI was applied. Patients in group C received PEI and RFA simultaneously. The clinical effects in the 3 groups were compared after 6‑month follow ups. The volume of tumor ablation necrosis in group A was significantly greater than that in the groups B and C, while the size was significantly smaller compared to groups B and C after ablation. For group A, the complete ablation rate was significantly higher than that in groups B and C, and the differences were statistically significant (P<0.05). Liver damage indices, including raising levels of glutamic‑pyruvic transaminase and total bilirubin, were significantly decreased in group A (P<0.05). The survival rate in group A was also significantly higher than in groups B and C (P<0.05). In conclusion, for patients with liver cancer in middle and advanced stages, the treatment method using PEI followed by RFA was more beneficial in terms of improving the tumor ablation rate, alleviating liver damages and increasing survival rates.

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1	Hou W and Zhu X: Extra vascular interventional treatment of liver cancer, present and future. Drug Discov Ther. 9:335–341. 2015. View Article : Google Scholar : PubMed/NCBI
2	Xu LT, Zhou ZH, Lin JH, Chen Z, Wang K, Wang P, Zhu XY, Shen YH, Meng ZQ and Liu LM: Clinical study of transarterial chemoembolization combined with 3-dimensional conformal radiotherapy for hepatocellular carcinoma. Eur J Surg Oncol. 37:245–251. 2011. View Article : Google Scholar : PubMed/NCBI
3	Kurokohchi K, Watanabe S, Masaki T, Hosomi N, Miyauchi Y, Himoto T, Kimura Y, Nakai S, Deguchi A, Yoneyama H, et al: Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma. World J Gastroenterol. 11:1426–1432. 2005. View Article : Google Scholar : PubMed/NCBI
4	Mulier S, Ni Y, Jamart J, Ruers T, Marchal G and Michel L: Local recurrence after hepatic radiofrequency coagulation: Multivariate meta-analysis and review of contributing factors. Ann Surg. 242:158–171. 2005. View Article : Google Scholar : PubMed/NCBI
5	Jarnagin WR: Management of small hepatocellular carcinoma: A review of transplantation, resection, and ablation. Ann Surg Oncol. 17:1226–1233. 2010. View Article : Google Scholar : PubMed/NCBI
6	Kim JW, Shin SS, Heo SH, Hong JH, Lim HS, Seon HJ, Hur YH, Park CH, Jeong YY and Kang HK: Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: how we do it safely and completely. Korean J Radiol. 16:1226–1239. 2015. View Article : Google Scholar : PubMed/NCBI
7	Zhang TT, Luo HC, Cui X, Zhang W, Zhang LY, Chen XP and Li KY: Ultrasound-guided percutaneous microwave ablation treatment of initial recurrent hepatocellular carcinoma after hepatic resection: long-term outcomes. Ultrasound Med Biol. 41:2391–2399. 2015. View Article : Google Scholar : PubMed/NCBI
8	Clark TW: Chemical ablation of liver cancer. Tech Vasc Interv Radiol. 10:58–63. 2007. View Article : Google Scholar : PubMed/NCBI
9	Sugiura Y, Iwasaka T and Tarumi N: Percutaneous ethanol injection therapy: A new treatment for hepatocellular carcinoma. Radiaology. 90:53–57. 1983.
10	Livraghi T, Giorgio A, Marin G, Salmi A, de Sio I, Bolondi L, Pompili M, Brunello F, Lazzaroni S and Torzilli G: Hepatocellular carcinoma and cirrhosis in 746 patients: Long-term results of percutaneous ethanol injection. Radiology. 197:101–108. 1995. View Article : Google Scholar : PubMed/NCBI
11	Rossi S, Di Stasi M, Buscarini E, Cavanna L, Quaretti P, Squassante E, Garbagnati F and Buscarini L: Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma. Cancer J Sci Am. 1:73–81. 1995.PubMed/NCBI
12	Kudo M: Radiofrequency ablation for hepatocellular carcinoma: Updated review in 2010. Oncology. 78(Suppl 1): 113–124. 2010. View Article : Google Scholar : PubMed/NCBI
13	Wahl DR, Stenmark MH, Tao Y, Pollom EL, Caoili EM, Lawrence TS, Schipper MJ and Feng M: Outcomes After Stereotactic Body Radiotherapy or Radiofrequency Ablation for Hepatocellular Carcinoma. J Clin Oncol. Nov 30–2015.(Epub ahead of print). PubMed/NCBI
14	Kai L, Jia L, Zhi-Gang W and Lei Y: Ultrasonic guided percutaneous ethanol injection with or without combined radiofrequency ablation for hepatocellular carcinomas. Indian J Cancer. 52(Suppl): E102–E104. 2015.PubMed/NCBI
15	Rehman J, Landman J, Lee D, Venkatesh R, Bostwick DG, Sundaram C and Clayman RV: Needle-based ablation of renal parenchyma using microwave, cryoablation, impedance- and temperature-based monopolar and bipolar radiofrequency, and liquid and gel chemoablation: laboratory studies and review of the literature. J Endourol. 18:83–104. 2004. View Article : Google Scholar : PubMed/NCBI
16	Ogasawara S, Chiba T, Ooka Y, Suzuki E, Kanogawa N, Saito T, Motoyama T, Tawada A, Kanai F and Yokosuka O: Post-progression survival in patients with advanced hepatocellular carcinoma resistant to sorafenib. Invest New Drugs. 14:1–3. 2016.
17	Shi F, Tan Z, An H, Wang X, Xu Y and Wang S: Hepatocellular carcinoma ≤4 cm treated with radiofrequency ablation with or without percutaneous ethanol injection. Ann Hepatol. 15:61–70. 2015.2016. View Article : Google Scholar : PubMed/NCBI
18	Fu Y, Zhao X, Yun Q, Zhu X, Zhu Y, Li Q, Hu K, Wang J and Qiao Z: Transarterial chemoembolization (TACE) plus percutaneous ethanol injection (PEI) for the treatment of unresectable hepatocellular carcinoma: A meta-analysis of randomized controlled trials. Int J Clin Exp Med. 8:10388–10400. 2015.PubMed/NCBI
19	Yang B, Zan RY, Wang SY, Li XL, Wei ML, Guo WH, You X, Li J and Liao ZY: Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials. World J Surg Oncol. 13:962015. View Article : Google Scholar : PubMed/NCBI
20	Huang H, Liang P, Yu XL, Cheng ZG, Han ZY, Yu J and Liu FY: Safety assessment and therapeutic efficacy of percutaneous microwave ablation therapy combined with percutaneous ethanol injection for hepatocellular carcinoma adjacent to the gallbladder. Int J Hyperthermia. 31:40–47. 2015. View Article : Google Scholar : PubMed/NCBI