Clinical study of Percutaneous Interstitial Nd-YAG Laser Hyperthermia for the Treatment of Hepatocellular Carcinoma

1999 Fiscal Year Final Research Report Summary

• Project/Area Number: 09670944
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Radiation science
• Research Institution: OITA MEDICAL UNIVERSITY
• Principal Investigator: MORI Hiromu OITA MEDICAL UNIVERSITY, MEDICINE, PROFESSOR, 医学部, 教授 (20128226)
• Co-Investigator(Kenkyū-buntansha): HORI Yuzo OITA MEDICAL UNIVERSITY, MEDICINE, ASSISTANTPROFESSOR, 医学部, 助手 (70295187) ; TAKEOKA Hiroshi OITA MEDICAL UNIVERSITY, MEDICINE, ASSISTANT PROFESSOR, 医学部, 助手 (20253792) ; MAEDA Tohru OITA MEDICAL UNIVERSITY, MEDICINE, ASSOCIATE PROFESSOR, 医学部, 助教授 (00157140)
• Project Period (FY): 1997 – 1999
• Keywords: Nd-YAG LASER / HEPATOCELLULAR CARCINOMA

Research Abstract

PURPOSE:
To determine the efficacy of percutaneous interstitial Nd-YAG laser hyperthermia (ILHT) in the treatment of hepatocellular carcinoma (HCC).
MATERIALS and METHODS:
Fifteen patients with 26 lesions of HCC (10mm-30mm in diameter, mean 17 mm; maximum diameters of 13 lesions were smaller than 15 mm) were treated with ILHT. ILHT was executed using continuous delivery of 2 watts for 15-20 minutes in 6 patients (7 lesions), pulse-mode delivery of 5 watts ( 1OOms intervals) for 5 minutes in 10 patients (17 lesions), and continuous delivery of 5 watts for 4 minutes in 2 patients (2 lesions), respectively. The therapeutic response was assessed with dynamic CT on 7-14 days, 1 month, and 2-6 months' after the treatment.
RESULTS:
The average number of ILHT sessions was 2.1. With a mean follow-up of 1 month, complete tumor necrosis was observed in 18 lesion (69%), and incomplete necrosis was seen in 8 lesions (31%). During follow-up for 2-24 months (mean, 7.1 months), local recurrence within or around a successfully treated lesion was seen in 14 lesions (78%). For minor complications, warm feeling and tolerable pain during the procedure were identified in all patients. Localized perihepatic hematoma was seen in 5 patients, and temporarily worsening of liver function was also seen in all patients. For major complications, there were tumor dissemination to the skin (n=1) and perforation of the colon (n=1).
CONCLUSION:
The effect of the ILHT at 2-5 watts on HCC was insufficient in this study. This is probably due to a cooling effect produced by the vessels such as hepatic artery and portal vein, which might protect adjacent tumor from the hyperthermia. Therefore, modified methods such as using balloon occlusion of hepatic artery or portal vein would be required for ILHT treatment.