Liu YE, Zong J, Chen XJ, Zhang R, Ren XC, Guo ZJ, Liu CX, Lin Q. Cryoablation combined with radiotherapy for hepatic malignancy: Five case reports. World J Gastrointest Oncol 2020; 12(2): 237-247 [PMID: 32104554 DOI: 10.4251/wjgo.v12.i2.237]
Corresponding Author of This Article
Qiang Lin, Professor, Department of Oncology, North China Petroleum Bureau General Hospital, Hebei Medical University, 8 Huizhan Avenue, Renqiu 062552, Hebei Province, China. zyy_lq@petrochina.com.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Feb 15, 2020; 12(2): 237-247 Published online Feb 15, 2020. doi: 10.4251/wjgo.v12.i2.237
Cryoablation combined with radiotherapy for hepatic malignancy: Five case reports
Yue-E Liu, Jie Zong, Xue-Ji Chen, Rui Zhang, Xiao-Cang Ren, Zhi-Jun Guo, Chao-Xing Liu, Qiang Lin
Yue-E Liu, Jie Zong, Xue-Ji Chen, Rui Zhang, Xiao-Cang Ren, Zhi-Jun Guo, Qiang Lin, Department of Oncology, North China Petroleum Bureau General Hospital, Hebei Medical University, Renqiu 062552, Hebei Province, China
Zhi-Jun Guo, Department of Radiology, North China Petroleum Bureau General Hospital, Hebei Medical University, Renqiu 062552, Hebei Province, China
Chao-Xing Liu, Department of Oncology, No.1 Hospital of Shijiazhuang City, Shijiazhuang 050000, China
Author contributions: Liu YE participated in the design of the subject and drafted the manuscript; Zong J, Chen XJ, Zhang R and Ren XC participated in the therapy for these five patients and the interpretation of data; Guo ZJ participated in the design of the subject and the interpretation of radiological data; Liu CX participated in the design of the subject and helped to the writing of the manuscript; Lin Q designed the subject and interpreted the data, who is responsible for the whole manuscript. All authors issued final approval for the version to be submitted.
Supported byHealth Commission of Hebei Province, No. G2018068.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the guidelines from the check list have been adopted in the preparation of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qiang Lin, Professor, Department of Oncology, North China Petroleum Bureau General Hospital, Hebei Medical University, 8 Huizhan Avenue, Renqiu 062552, Hebei Province, China. zyy_lq@petrochina.com.cn
Received: May 21, 2019 Peer-review started: May 21, 2019 First decision: September 20, 2019 Revised: October 28, 2019 Accepted: December 13, 2019 Article in press: December 13, 2019 Published online: February 15, 2020 Processing time: 271 Days and 1.6 Hours
Abstract
BACKGROUND
The survival of patients treated with monotherapy for hepatic malignancies is not ideal. A comprehensive program of cryoablation combined with radiotherapy for the treatment of hepatic malignancies results in less trauma to the patients. It may provide an option for the treatment of patients with advanced hepatic malignancies.
CASE SUMMARY
We reported 5 cases of advanced-stage hepatic malignancies treated in our hospital from 2017-2018, including 3 cases of primary hepatocellular carcinoma and 2 cases of metastatic hepatic carcinoma. They first received cryoablation therapy on their liver lesions. The procedure consisted of 2 freeze-thaw cycles, and for each session, the duration of freezing was 13-15 min, and the natural re-warming period was 2-8 min. Depending on the tumor size, the appropriate cryoprobes were selected to achieve complete tumor ablation to the greatest extent possible. After cryoablation surgery, intensity-modulated radiotherapy (IMRT) for liver lesions was performed, and the radiotherapy regimen was 5400 cGy/18f and 300 cGy/f. None of the 5 patients had adverse events above grade II, and their quality of life was significantly improved. Among them, 4 patients were free of disease progression in the liver lesions under local control, and their survival was prolonged; 3 patients are still alive.
CONCLUSION
Our clinical practice demonstrated that cryoablation combined with IMRT could be implemented safely. The definitive efficacy for hepatic malignancies needs to be confirmed in larger-size sample prospective studies.
Core tip: The therapeutic efficacy of monotherapy for primary hepatocellular carcinoma (HCC) and secondary HCC is usually poor, and thus, combination therapy is needed. A treatment plan of cryoablation combined with radiotherapy is safe and effective and may result in survival benefits to patients.
