Published online Jun 14, 2017. doi: 10.3748/wjg.v23.i22.4080
Peer-review started: December 12, 2016
First decision: December 29, 2016
Revised: February 15, 2017
Accepted: March 4, 2017
Article in press: March 4, 2017
Published online: June 14, 2017
Processing time: 185 Days and 15.1 Hours
To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer.
A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group (n = 56, 65 tumors) and 64-slice group (n = 8, 77 tumors). All patients were accepted and received targeted therapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion (HAP), portal vein perfusion (PVP), and the hepatic arterial perfusion index (HAPI)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding.
Guided scan times in the dual-slice group was longer than that in the 64-slice group (t = 11.445, P = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group (81.58%) was lower than that in the 64-slice group (92.86%) (χ2 = 5.707, P = 0.017). The HAP and HAPI of tumor tissues were lower at four weeks post-treatment than at pre-treatment in both groups (all P < 0.05), and those in the 64-slice group were lower than that in the dual-slice group (all P < 0.05). HAP and PVP were lower and HAPI was higher in tumor adjacent tissues at post-treatment than at pre-treatment (all P < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment (all P < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group (all P < 0.05).
64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.
Core tip: One hundred and twenty-four patients with liver cancer were accepted therapy by argon-helium superconducting surgery system. Compared with 64-row group, guided scan times was longer and freezing effective rate for tumors < 3 cm was lower in the dual-slice group. Four weeks after treatment, compared with dual-slice group, the hepatic artery perfusion and hepatic arterial perfusion index of tumor tissues were lower, the treatment effect and therapeutic efficacy in the 64-row group were higher. Complications were higher in the double-row group than in the 64-row group. 64-slice spiral computed tomography applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment.