Efficacy and safety of HIFU in combination with TACE in unresectable pediatric HB: A randomized, controlled, single-center clinical trial

Abstract

Background: Hepatoblastoma (HB) is the most common liver tumor in children, and the main treatment for HB is currently surgery. Studies have shown that transcatheter arterial chemoembolization (TACE) combined with high intensity focused ultrasound (HIFU) has significant efficacy, but there are relatively few studies on TACE combined with HIFU in China. Objective: To investigate the effect of using HIFU combined with TACE on patients’ liver function impairment and immune function in pediatric HB patients and to analyze the effectiveness and safety. Materials and methods: The clinical data of 110 unresectable pediatric HB patients treated in our hospital from December 2019 to December 2021 were selected as the subjects and divided into 2 groups. The comparison group was treated with TACE, and the combination group was treated with HIFU on the basis of the comparison group. The differences in immune function, survival, treatment side effects and clinical efficacy between the 2 groups were observed. Results: In the combined group, the 1-year survival rate was 100%, the 3-year survival rate was 84.0%, the 5-year survival rate was 16.0%; while in comparison group, it was 82%, 16%, 0%, respectively. The ratio of CD4+/CD8+ in the combined group were significantly higher than in the comparison group after treatment (P < .05). Granulocytopenia, mucositis, thrombocytopenia, and cardiac and renal toxicity were significantly lower in the combined group than in the comparison group, and the effective rate of the combined group was 98.00% which was significantly higher than that of the control group (76.00%) (P < .05). Conclusion: Comparative study of HB in children treated with HIFU combined with TACE is more effective, effectively improving the immune level of patients, significantly increasing the remission rate, which can improve the tumor necrosis and improve the survival quality of patients, and is a better choice for HB in children.

An update on diagnosis and treatment of hepatoblastoma

“…Tumor markers were reduced to normal (69). The results of another randomized controlled trial suggested that 110 patients with unresectable hepatoblastoma treated with High Intensity Focused Ultrasound (HIFU) combined with TACE regimen had higher survival rates of 100%, 84%, and 16% at 1, 3, and 5 years, respectively (70). The above results support that TACE and various treatment options in combination with TACE may have some efficacy in difficult-to-resect hepatoblastoma, leading to longer survival times.…”

Prognostic value of systemic inflammation response index in hepatoblastoma patients receiving preoperative neoadjuvant chemotherapy

“…The nomogram prediction model, which incorporates SIRI and clinicopathologic factors, has shown good predictive ability, suggesting its potential usefulness as a valuable tool for clinicians in formulating appropriate personalized treatment strategies. Moreover, alternative techniques, such as transarterial chemoembolization (TACE), radiofrequency ablation (RFA), and high-intensity focused ultrasound (HIFU), have been utilized in pediatric oncology ( 67 – 69 ). These techniques hold promise for patients with high preoperative inflammatory indexes, as they may effectively control tumor growth and allow for postponement of surgical treatment, leading to potentially improved outcomes for these children.…”