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Original Article

Combined radiofrequency and chemoembolization vsvs. .
Combined radiofrequency and chemoembolization
chemoembolization in management of hepatocellular
chemoembolization in management of hepatocellular
carcinoma
carcinoma

2
1
2
Ahmed Kamal El Dorry , Eman Mahmoud Fathy Barakat , Amal Tohamy Abd ElMoez ,
3
3
Mervat Abd Fatah Mawad , Nevien Fouad El-Fouly , Mohamed Kamal Shaker 2
1 Department of Radiology Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
2 Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
3 Atomic Energy Authority, Cairo 13759, Egypt
ABSTRACT
Aim: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. If left untreated, liver cancer has a
poor prognosis with more than 90% of patients dying of the disease within 5 years of diagnosis. The aim of this study is to
assess the value of combined radiofrequency ablation (RFA), followed by trans-arterial chemoembolization (TACE) in the
management of HCC. Methods: Fifty HCC patients with chronic liver disease were categorized into two groups according to
the modality of locoregional treatment: 25 HCC patients treated with RFA followed by TACE within 5 days and 25 HCC patients
treated with TACE only. Results: Complete response was achieved in 100% and 84% of the HCC patients after 1 month
from combined RFA-TACE therapy and TACE only respectively. The rate of objective response after 7 months was 84% and
44% in the RFA-TACE and TACE groups respectively. One year disease free survival rate was 56% and 24% in RFA-TACE
and TACE groups respectively, and overall survival rate was 88% in the RFA-TACE group and 80% in the TACE only group.
Conclusion: Combined RFA-TACE appears to be an effective modality and superior to TACE only for the treatment of HCC.

Key words: Hepatocellular carcinoma; radiofrequency; trans-arterial chemoembolization

Address for correspondence:
Dr. Amal Tohamy Abd ElMoez, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
E-mail: d_amal_tohamy@yahoo.com
Received: 27-12-2014, Accepted: 23-02-2015

INTRODUCTION of unaffected hepatic parenchyma. The greatest
[3]
success rate was achieved in non-infiltrating tumors of
[4]
Hepatocellular carcinoma (HCC) is the fifth most common sizes 3-5 cm. Trans-arterial chemoembolization (TACE)
cancer in the world, with over 600,000 new diagnoses/year. is an intra-arterial infusion of chemotherapy, which
[1]
In Egypt, the annual incidence of HCC showed a significant blocks (embolizes) small blood vessels, depriving the tumor
rising trend from 4.0% in 1993 to 7.2% in 2002. of its needed blood supply. However, this procedure is
[2]
[5]
Radiofrequency ablation (RFA) is a locoregional modality for not curative. The combination of RFA and TACE induces
coagulative necrosis in large areas without any possibility
tumor ablation which often allows for greater preservation
of revascularization. [6]
Access this article online
Quick Response Code The aim of this study was to assess the efficacy of combined RFA
Website: followed by chemoembolization in the management of HCC.
http://www.hrjournal.net/
METHODS
DOI:
10.4103/2394-5079.154355 This cross-sectional randomized controlled prospective study
was performed at the HCC Clinic at Ain Shams University.

Hepatoma Research | Volume 1 | Issue 1 | April 15, 2015 19