Clinical results of radiofrequency hyperthermia for malignant liver tumors

Nagata, Yasushi; Hiraoka, Masahiro; Nishimura, Yasumasa; Masunaga, S.; Mitumori, Michihide; Okuno, Yoshishige; Fujishiro, Masayo; Kanamori, Shuichi; Horii, Naotoshi; Akuta, Keizo; Sasai, Keisuke; Abe, Mitsuyuki; Fukuda, Yoshihiro

doi:10.1016/s0360-3016(96)00625-6

Cited by 79 publications

(49 citation statements)

References 13 publications

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“…The use of radiofrequency (RF) energy to produce thermal tissue destruction has been the focus of increasing research and practice for the past several years [16][17][18][19]. During the application of RF energy, a high frequency alternating current moves from the tip of an electrode into the tissue surrounding that electrode.…”

Section: Background and Basics Of Radiofrequency Tissue Ablationmentioning

confidence: 99%

“…By temporarily occluding hepatic inflow during RFA, the cooling effect of blood flow on perivascular tumor cells is minimized [27]. The inflow occlusion increases the size of the zone of coagulative necrosis and Curley 19 enhances the likelihood of complete tumor cell kill, even if the tumor abuts a major intrahepatic blood vessel. Our previous preclinical work demonstrated that RFA treatment combined with vascular inflow occlusion can produce complete circumferential necrosis of tissue around major portal or hepatic vein branches without damaging the integrity of the vessel wall [23].…”

Section: Rfa Treatment Approachesmentioning

confidence: 99%

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Radiofrequency Ablation of Malignant Liver Tumors

2001

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The majority of patients with primary or metastatic hepatic tumors are not candidates for resection because of tumor size, location near major intrahepatic blood vessels precluding a margin-negative resection, multifocality, or inadequate hepatic function related to coexistent cirrhosis. Radiofrequency ablation (RFA) is an evolving technology being used to treat patients with unresectable primary and metastatic hepatic cancers. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode. For tumors smaller than 2.0 cm in diameter, one or two deployments of the monopolar multiple array needle electrode are sufficient to produce complete coagulative necrosis of the tumor. However, with increasing size of the tumor, there is a concomitant increase in the number of deployments of the needle electrode and the overall time necessary to produce complete coagulative necrosis of the tumor. In general, RFA is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies less than 6.0 cm in diameter. Effective treatment of larger tumors awaits the development of more powerful, larger array monopolar and bipolar RFA technologies.

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Section: Background and Basics Of Radiofrequency Tissue Ablationmentioning

confidence: 99%

Section: Rfa Treatment Approachesmentioning

confidence: 99%

Radiofrequency Ablation of Malignant Liver Tumors

2001

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“…Hyperthermia combined with transcatheter arterial embolization, radiotherapy, immunotherapy, and chemotherapy has been reported in cases of liver tumors (18). It has been reported that moderate hyperthermia increases the cytotoxicity of irinotecan, docetaxel, and gemcitabine on mouse fibrosarcoma (19).…”

Section: Case Reportmentioning

confidence: 99%

Advanced hepatocellular carcinoma treated effectively with irinotecan via hepatic arterial infusion followed by proton beam therapy

Ohtsubo

Watanabe

Tsuchiyama

et al. 2009

Journal of Infection and Chemotherapy

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We report a 48-year-old man with hepatocellular carcinoma (HCC) treated with hepatic arterial infusion (HAI) chemotherapy followed by proton beam therapy. The HCC lesion in this patient was 8.8 cm in diameter with portal vein tumor thrombosis in the right robe of the liver. He was first treated with 5-fluorouracil, cisplatin, and isovorin, combined with interferon-α, and subsequently with epirubicin and mitomycin-C by HAI. However, no definite efficacy was observed. After continuous administration of irinotecan by HAI, the tumor size decreased to 6.8 cm in diameter after 3 weeks. The tumor became enlarged to 10 cm in diameter after 3 months.Angiographic findings indicated that HCC was fed from not only the right hepatic artery, but also the left gastric and right and left subphrenic arteries. After rearrangement of the arteries, the tumor size decreased to 5.0 cm in diameter by continuous HAI chemotherapy with irinotecan and hyperthermia after 4 months. Since the reduction rate 4 of the main tumor was 43% in Response Evaluation Criteria in Solid Tumors, the efficacy of this case was judged partial response. Although liver tumors showed gradual enlargement during administration of docetaxel instead of irinotecan, almost of the liver tumors resulted in necroses after proton beam therapy. The patient died of hepatic failure and distant metastases 6 years after onset of HCC. As far as we know, this is the first case report of HCC treated effectively with irinotecan by HAI followed by proton beam therapy in which tumor suppression and long-term survival were observed.

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“…A variety of other interstitial local approaches have been applied to liver metastases, including microwave, 112 radiofrequency, 113 and focused highintensity ultrasound ablation. 114 The use of local irradiation using 90 yttrium seed implants has also been reported.…”

Section: Cryosurgery and Other Forms Of Local Hepatic Ablative Therapymentioning

confidence: 99%

Management of hepatic metastases

Choti

Bulkley

1999

Liver Transpl

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Although the liver is the most common site of metastatic disease from a variety of tumor types, isolated hepatic metastases most commonly occur from colorectal cancer and, less frequently, from neuroendocrine tumors, gastrointestinal sarcoma, ocular melanoma, and others. Complete evaluation of the extent of metastatic disease, both intrahepatically and extrahepatically, is important before considering treatment options. Based on a preponderance of uncontrolled studies for hepatic metastatic colorectal carcinoma, surgical resection offers the only potential for cure of selected patients with completely resected disease, with 5-year survival rates of 25% to 46%. Systemic and hepatic arterial infusion chemotherapy may be useful treatment options in patients with unresectable disease and possibly as an adjuvant treatment after liver resection. Other techniques of local tumor ablation, including cryotherapy and radiofrequency ablation, although promising, remain unproved. Management of hepatic metastases from neuroendocrine tumors and other noncolorectal primary tumors should be individualized based on the patient's clinical course, extent of disease, and symptoms. Copyright 1999 by the American Association for the Study of Liver DiseasesA s many as 50% of the patients with a primary malignancy will eventually develop metastases in the liver, a percentage greater than for any other organ, including the lung. Although primary tumors that drain principally into the portal circulation are more likely than others to develop hepatic metastases, many tumors arising in other sites, such as the breast and lung, also commonly develop hepatic metastases. Although the liver represents a common site of spread from many of these solid tumors, isolated hepatic metastases most commonly occur from colorectal and neuroendocrine tumors. Other less common malignancies also can metastasize predominantly to the liver. For most other solid malignancies, the pattern of metastatic disease is most often that of generalized dissemination. Colorectal MetastasesCancer of the colon and rectum is the third most commonly diagnosed cancer in the United States. An estimated 131,600 new cases will have been discovered in 1998, comprising 11% of new cancer diagnoses. 1 An estimated 56,500 deaths will occur from colorectal cancer that year, comprising 10% of all cancer deaths. 1 Although mortality from largebowel cancer has been improving over the past 30 years, largely because of improvements in early detection, diagnosis, and treatment, approximately 50% of the patients with colorectal cancer eventually die of their neoplastic disease. 1 The liver is the most commonly involved organ in patients with metastatic colorectal cancer. Approximately 20% of these patients have clinically recognizable liver metastases at the time of their primary diagnosis. 1,2 After resection of a primary colorectal cancer in the absence of apparent metastatic disease, approximately 50% of the patients will subsequently manifest metastatic liver disease. Given these figures,...

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Clinical results of radiofrequency hyperthermia for malignant liver tumors

Cited by 79 publications

References 13 publications

Radiofrequency Ablation of Malignant Liver Tumors

Radiofrequency Ablation of Malignant Liver Tumors

Advanced hepatocellular carcinoma treated effectively with irinotecan via hepatic arterial infusion followed by proton beam therapy

Management of hepatic metastases

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