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Objective To the curative effect of treating liver cancer with the Qinggan-Jiedu decoction adjuvant microwave coagulation therapy. Methods A total of 63 liver cancer patients were randomly divided into the treatment group (n=35) and the control group (n=28). On the basis of this, the control group was treated only with microwave coagulation therapy, while the treatment group was treated with Qinggan-Jiedu decoction for 14 days on the basis of the control group. Before and after treatment, Karnofsky Performance status score (KPS) was used to evaluate the quality of life, and the changes of symptoms and signs such as fever, anorexia, abdominal distention and liver pain were observed, and the changes of tumor focus were observed by B-mode ultrasonography. Blood routine, ALT, AST, TBil and tumor markers were detected by ELISA. Results The total effective rate was 71.4％ (25/35) in the treatment group and 46.4％ (13/28) in the control group. There was significant difference between the two groups (χ2=4.062, P=0.044). After treatment, the KPS scores of the two groups (86. 6 ± 9. 6 vs. 80. 4 ± 7. 9, t=2.751) were higher than those of the control group (P=0.008). The scores of ALT (59.4 ± 27.6 U/L vs. 85.1 ± 30.8 U/L, t=3.488) and AST (53.9 ± 24.4 U/L vs. 82.3 ± 27.6 U/L, t=4.331) in the treatment group were lower than those in the control group (P<0.01). After treatment, the liver focus disappeared in both groups. Conclusions Qinggan-Jiedu decoction can reduce the degree of liver injury and improve the quality of life in liver cancer patients after microwave coagulation therapy.
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Objective:To explore the effect of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy(PMCT) on treatment of patients with hepatic carcinoma.Methods: The clinical data of 60 cases of liver cancer patients in our hospital in TACE combined with PMCT were analyzed. Results:The operation was successfully performed, no serious complications and death. Efficacy: 4 CR cases, 38 PR cases, 16 SD cases, 2 PD cases, the total efficiency of treatment was 70.0%; After 1, 2, 3 year, survival cases (ratio) were respectively: 46(76.7%), 35(58.3%), 31(51.7%); The levels of Serum alpha fetoprotein (AFP) after operation was significantly reduced, after treatment, the patient's liver function improved significantly; The diameter of the lesions was significantly reduced.Conclusion: TACE combined with PMCT is an effective therapy for hepatic carcinoma.
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Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.
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Objective To evaluate the viability of residual tumor after insufficient thermal ablation of rabbit VX2 liver tumor and investigated the efficacy of sorafenib as an adjuvant therapy.Methods Twenty-one rabbits were implanted with VX2 tumor to establish orthotopic liver tumor models.They were allocated randomly into 3 groups:control (n =7),ablation (n =7),and combination treatment (n =7).Microwave coagulation therapy was conducted with 20 W for 1 min and viable tumor tissue remained at the periphery.A laparotomy was performed in the control group.Sorafenib was given at 20 mg/kg/d during the following 10 days in the combination treatment group,and saline was given to the control and ablation group.Tumor volume was recorded before and after treatment,immunohistochemistry detected CD31 and proliferating cell nuclear antigen (PCNA) expression,and the micro-vessel density (MVD) and proliferation index (PI) were calculated accordingly.Results Ten days after insufficient ablation,tumor volume of the ablation group was larger than that of the control group (P ＜0.05).The MVD and PI of residual tumor were higher compared with those of the control group (P ＜ 0.05).With adjuvant therapy of sorafenib after insufficient ablation,tumor volume showed a decrease on the 10th day compared with tumors undergoing insurfficient ablation alone (P ＜ 0.05).The MVD and PI of residual tumor were lower than those of the ablation group (P ＜0.05).Conclusion Insufficient thermal ablation promotes residual tumor progression,but adjuvant therapy of sorafenib serves as an effective way to suppress the overgrowth and neovasculation of the residual tumor.
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Objective To study the results of repeat hepatectomy,followed by transcatheter arterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT),but with or without portal vein chemotherapy (PVC) in patients with recurrence of hepatocelluar carcinoma (HCC) after partial hepatectomy.Methods The data of 33 patients were analyzed retrospectively.All these patients received repeat hepatectomy.They were then divided into two groups:the PVC group (n =19) was treated with PVC + TACE + PMCT,and the non-PVC group (n =14) with TACE + PMCT.Results For the 33 patients,13 (39.4％) developed tumor recurrence ＞2 years from the initial resection while 20 patients (60.6％) developed recurrence within ≤ 2 years.The tumor recurrence consisted of local recurrence in 14 patients (42.4％),and heterochronous recurrence in 19 patients (57.6％).There was a significantly difference in the cumulative survival rates between the two groups (x2 =4.319; P =0.038).The 1y,3y,5y survival rates were 84.2％,42.1％,31.6％ in the PVC Group,and 71.4％,28.6％,14.3％ in the Non-PVC Group respectively.28 sessions of PMCT and 97 sessions of TACE were performed postoperatively (the medians were 1,0.5; 3,3 respectively,the mean ranks were 17.68,16.07; 15.05,19.64 respectively,and the P values were 0.612,0.163 respectively between the two groups).Conclusions For patients with recurrence of HCC after hepatic resection,after repeat hepatectomy PVC + TACE + PMCT gave better survival than those with TACE + PMCT but without PVC.
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Objective:To evaluate the clinical value of percutaneous microwave coagulation therapy for peripheral non-small-cell lung cancer. Methods:We evaluated 35 patients with non-small-cell lung cancer who received percutaneous microwave coagulation therapy and 35 patients who received radiotherapy from March 2004 to September 2006;the patients were sex-matched, age-matched, and had the same pathology and clinical staging. Clinical effects were observed and assessed. Survival rate were calculated using the Kaplan-Meier method. The difference in survival rate between the two treatment methods was analyzed using a log-rank test. Results:The 1-year, 3-year, and 5-year survival rates for the microwave coagulation therapy group (71.4%, 40.0%, and 20.0%, respectively) were significantly higher than those for the radiation therapy (51.4%, 22.9%, and 11.4%, respectively) (P<0.05). Conclusion:Percutaneous microwave coagulation therapy is a minimally invasive, safe, and effective alternative for patients with peripheral non-small-cell lung cancer who cannot undergo routine surgery because of poor heart and lung function or fear of surgical trauma.
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Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.
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OBJECTIVE: To study some thermal problems in invasive microwave coagulation (IMC) therapy. METHODS: Temperature fields predicts, limitation and remedy methods of the Pennes bioheat transfer equation during the temperature distribution analyses and how to kill a large anomalistic tumor for only once were discussed. RESULTS: The coagulation area between the simulations and actual measured results showed good correspondence. Blood flow influenced the rise in temperature significantly. CONCLUSIONS: Thermal distribution with computer simulation in invasive microwave coagulation therapy is an accurate and reliable method.
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Computer Simulation , MicrowavesABSTRACT
Objective To explore clinical indications and curative effects of microwave coagulation combined with submucous 5-fluorouracil (5-FU) injection in the management of early-stage lower rectal cancer. Methods Nine patients with early-stage lower rectal cancer underwent microwave coagulation with submucous 5-FU injection from January 1996 to December 2002. After the microwave treatment, a retention enteroclysis with 100~200 ml normal saline containing 1.0 g 5-FU was performed once daily for 3 days. Results In 3 patients, levels of carcinoembryonic antigen (CEA), which were preoperatively increased, were reduced below normal limits after microwave treatment. No hemorrhage or other intra- or post-operative complications was observed. Follow-up observations to January 2006 showed that all the 9 patients survived. One patient survived for 3 years and 5 months, 1 patient survived for 3 years and 8 months, and 1 patient experienced a tumor relapse at 1 year and 4 months and survived for 2 years and 9 months after a Miles procedure. Among 6 patients who survived longer than 5 years, 1 survived for 5 years and 1 month, 1 for 6 years and 3 months, 1 for 6 years and 8 months, 1 for 7 years and 6 months, and 2 for 9 years. Conclusions Surgical indications for microwave coagulation combined with submucous 5-FU injection for rectal cancer included early-stage cancer, lesions located within 7 cm away from the anus, the mass type cancer, tumor diameter at 0.5~3.0 cm or less than one third of the rectum’s circumference, well differentiated tumor, and patient’s strong anus-sparing demand. This method is minimally invasive, safe, reliable, and cost-effective.
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Objective:To observe the morphological changes in skeletal muscles after therapeutic. Methods:Tibialis anterior muscles of 25 New Zealand rabbits were exposed and coagulated with 70 W for 20 s. The rabbits were sacrificed at 1 hour?24 hours?48 hours?1 week and 2 months after MCT. The specimens of coagulated areas were prepared for histological observation. Results:Obvious rims could be found bet ween coagulated and normal tissues .The ablated site showed tissue fixation in the inner zone and coagulative necrosis in found the outer zone.these were four zones can be seen under high powered magnification:the application zone,the central zone,the transition zone and the reference zone. Demarcation zone of necrosis appeared 24h after MCT. Tibrosis encapsulation occurred after 7 days.Replacement with fine cicatrix was demonstrated after 2 months. Conclusion:Tissue destroyed by coagulation can be replaced with a fine cicatrix gradually.
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Objective To evaluate the efficacy and feasibility of percutaneous microwave coagulation therapy(PMCT) combined with 125I seeds implantation for the treatment of advanced lung cancer.Methods CT-guided PMCT and implantation of 125I seeds were applied to 22 cases of NSCLC,including 15 cases of squamous carcinoma and 7 cases of adenocarcinoma.The maximum diameter of the lesions ranged from 5-12 cm.The part of focuses situated at thoracic wall or surrounding the large vessels and airways was treated with 125I seed implantation,and the other parts were treated with PMCT. Results In all the patients,PMCT was done in one session with multipoint ablation,and an average of 32.4 particles of 125I seeds were implanted for each of the focuses(712 particles in total).The main postoperative complications included slight hemoptysis(7 cases),pneumothorax(4 cases),fever(17) and lung inflammation(11) after PMCT,chest fluid(6),and dislocation of the particles(2).15 cases achieved PR,5 cases were SD,and 2 cases were PD in 2 months after the operation shown by CT.The effective rate(CR + PR) was 68.2%(15/22).The chest pain was relieved in 15 patients,and improved in 4.22 of the cases were followed up for 4 to 18 months(mean 7 months).No enlargement of the chest lesion was detected during the period. Conclusions For the advanced NSCLC sized ≥ 5 cm in diameter,PMCT combined with 125I seeds implantation is safe,minimally invasive,and effective.
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Objective To investigate the prognosis of cervical intraepithelial neoplasia (CIN) Ⅱ and Ⅲ after being treated by microwave coagulation, loop electrosurgical excision procedure (LEEP) and cold knife conization. Methods From March 2000 to February 2006, 289 patients with CIN Ⅱ or Ⅲ diagnosed by colposcopic biopsy were treated and followed up according to consensus guidelines for the management of women with CIN. Results Totally 233 of the 289 patients (80.6%) completed the follow-up (3-56 months with a mean of 11.8). Among them, 77.7% (181/233) received treatment; the other 22.3% (52/233) did not. In the 181 patients who received treatment, the lesion disappeared in 160 (88.4%) cases, during the follow-up; while in those who did not received treatment, the CIN was cured spontaneously in 63.5% (33/52; ?2=17.664, P=0.000). The prognosis of CIN Ⅱ was similar among the patients who were treated with microwave coagulation, LEEP, or cold knife conization (?2=0.008,P=0.996). In addition, in the patients with CIN Ⅲ, the prognosis after cold knife conization was not significantly different from that after LEEP (?2=0.017,P=0.897). Conclusions The management of CIN Ⅱ and Ⅲ may increase the cure rate. However, the three therapeutic methods produce similar prognosis.
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Objective To explore the clinical value of B ultrasound-guided psychro-circulation percutaneous microwave coagulation therapy(PMCT) in the treatment of liver cancer.Methods One hundred and sixteen liver cancer patients with 154 lesions were selected to receive psychro-circulation PMCT in our department from July 2004 to December 2007.The pre-and postoperative alpha fetoprotein(AFP) levels were detected.The diameters and blood flow state of the tumors were measured and compared by use of B ultrasound and computerized tomographic scanning(CT).The postoperative 1,2 and 3 y survival rate of those patients was followed up and recorded.Results No mortality or severe complications occurred in this series.Preoperative serum AFP level of the patients was(421.6?36.5)?g/L and decreased obviously to(232.5?25.6)?g/L at 1 month after psychro-circulation PMCT(P
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Objective To evaluate the clinical effects,CT features and side-effects of percutaneous microwave coagulation therapy(PMCT) in the treatment of peripheral lung cancer.Methods CT-guided PMCT was applied to 16 cases of peripheral lung cancer from August 2003 to October 2004 in this hospital.Pathological or cytological findings showed 9 cases of squamous carcinoma and 7 cases of adenocarcinoma.A needle microwave antenna was applied into the tumor percutaneously under CT guidance.In each emission of microwave,the tumor was ablated with a 2 450 Hz microwave coagulation output of 65~75 W for 3~5 min.According to the size and shape of the tumor,single or multiple ablation emission was selected.Results The operation time was(15~60) min(mean,35 min).Complete remission(CR) was achieved in 1 case,partial remission(PR) in 4 cases,and no changes(NC) in 11.Follow-up observations in the 16 cases for 3~15 months(mean,9.5 months) found 2 cases of tumor metastasis and 1 case of death.Conclusions Percutaneous microwave coagulation therapy is a safe,micro-invasive,and effective treatment for the management of peripheral lung cancer.
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Objective:To observe the morphologic changes of cancer tissues and cells and clinical effect of microwave coagulation therapy (MCT) on oral squamous cell carcinoma.(OSCC), and then to evaluate the possibility of MCT in OSCC treatment.Methods:Forty OSCC patients were involved. MCT was adopted to the treatment of tumor primary focus, and associated with chemotherapy and lymphadenectomy of suprahyoid region or therapeutic neck dissection. After MCT the tissues were extracted for pathological examination immediately and morphologically observated by transmission electron microscope(TEM). All patients were received follow-up investigation for 3 years. The therapeutic effects of the two groups were observed and compared.Results:After MCT, the tissues of primary focus showed degenerative and necrotic tissue, inflammatory granulation, exudative necrosis, hyperplasia or atypical hyperplasia under light microscope. Apoptosis and mastocytes were observed besides the primary focus through TEM. Additionally MCT could protect oral faction, facies and improve survival quality and control local recurrence, which was more advanced than other old method (P