Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1580
Peer-review started: September 20, 2020
First decision: December 4, 2020
Revised: December 22, 2020
Accepted: January 8, 2021
Article in press: January 8, 2021
Published online: March 6, 2021
Percutaneous radiofrequency ablation (RFA) is an effective treatment for unresectable hepatocellular carcinoma (HCC). In recent years, angiographic systems with flat panel image detectors can use cone-beam computed tomography (CBCT) to guide RFA and show great effectiveness.
To assess the short-term response, radiation dose, and time to progression associated with CBCT guided RFA in HCC patients.
To assess radiation dose during operation, short-term response, and time to progression in HCC patients undergoing CBCT guided RFA.
Our prospective research studied HCC patients who underwent CBCT guided RFA. The basic status of the patients, including age, sex, Barcelona Clinic Liver Cancer stage, Child-Pugh score, tumour size and tumour adjacency to major vessels, the diaphragm, or other organs, was recorded. The radiation dose during RFA, short-term response, and time to progression were recorded during the follow-up.
There were 48 patients (44 males and 4 females) who underwent RFA guided by CBCT without major complications. The median tumour size was 3.2 cm (range 1.2-6.6 cm). The median dose area product of the procedures was 79.05 Gy*cm2 (range 40.95-146.24 Gy*cm2), and the median effective dose was 10.27 mSv (range 5.32-19.01 mSv). The post-RFA initial clinical assessment using contract-enhanced CT or magnetic resonance imaging showed 38 (79.2%) cases of complete response, 10 (20.8%) of partial response, 0 of stable disease, and 0 of progressive disease. The median time to progress was 12.8 mo.
CBCT guided RFA is a reliable treatment for HCC patients. It could enhance tumour visualization and contribute to satisfactory treatment responses. This is particularly beneficial for interventional oncologists who have limited access to dedicated CT and/or ultrasound units for therapeutic purposes.
The current study did not use contrast-enhanced CBCT to conduct the post-RFA immediate response assessment, and further investigations, particularly those incorporating intravenous contrast injection, might be clinically meaningful.