Laser-Induced Thermotherapy Combined With Hepatic Arterial Embolization in the Treatment of Liver Tumors in a Rat Tumor Model

Abstract

ObjectiveTo assess the effect of combined laser-induced thermotherapy (LITT) and hepatic arterial embolization with degradable starch microspheres (DSM) on tumor response and intrahepatic temperature distribution in rats with liver tumors. Summary Background DataLaser-induced thermotherapy is a promising in situ ablation technique for malignant liver tumors. However, clinical use is still limited, mainly because of the small size of the inducible coagulation necroses. This results in insufficient tumor destruction. MethodsColon carcinoma CC531 was implanted in 60 WAG rat livers. Fourteen days later, a silicon catheter was implanted in the hepatic artery for DSM administration. Tumors were exposed to 1064 nm Nd:YAG laser light at 2 watts for 10 minutes from a diffuser tip applicator placed in the tumor. The animals were randomized into a sham-operated control (group I) and three test groups. Group II received DSM alone, group III received LITT alone, and group IV received DSM ϩ LITT. Tumor control was examined 1, 7, and 14 days after treatment. ResultsA complete tumor remission was achieved in all rats treated with LITT ϩ DSM (group IV). In contrast, tumor progression was seen in animals treated with LITT alone (group III) or DSM alone (group II), as well as in the sham-operated controls (group I). ConclusionsThe authors' results suggest that the combination of LITT and DSM considerably increases the efficacy of LITT in the treatment of liver metastases in the rat.Laser-induced thermotherapy (LITT) or interstitial laser thermotherapy is an in situ ablation technique for the treatment of malignant tumors of the liver.

Laser‐induced thermotherapy (LITT) elevates mRNA expression of connective tissue growth factor (CTGF) associated with reduced tumor growth of liver metastases compared to hepatic resection

“…Staining was performed using the 5-bromo-2-deoxyuridine Labeling Kit II (Boehringer, LaRoche, Mannheim, Germany) as described previously [20]. In group II (resection), R0 resection of the tumor was detected as absence of vital tumor cells in the H&E stained sections and mere absence of immunohistochemical detection of BrdU.…”

Laserinduced thermotherapy (LITT) of experimental livermetastasis—detection of residual tumors using Gd‐DTPA enhanced MRI

“…For this reason, suboptimal (groups I-III) and optimal treatment parameters (group IV) were applied in liver tumor therapy. Suboptimal treatment parameters were evaluated based on our preliminary studies [18,19] and on data from the literature about complete thermocoagulation of experimental liver tumors [20,21]. In our study, statistical analysis of SI's rel was possible for 47 tumor recurrences and 33 recurrencefree courses ( Table 1).…”

Minimal invasive Onkologie in der Therapie von Lebermetastasen

“…Verschiedene Autoren beschreiben für intraoperative Ablationen das Pringle-Manöver mit temporärem Abklemmen der Pfortader, um die Nekrosegrößen positiv zu beeinflussen [24,33]. Perkutane Beeinflussungen der Tumor-oder Leberperfusion mittels arterieller Partikelembolisation oder auch temporärer Ballonblockade der Pfortader sind möglich, haben sich aufgrund des erheblichen Mehraufwandes jedoch nicht durchgesetzt [34]. …”