Stephan Zangos MD, Presenter: Nothing to Disclose

Katrin Eichler MD, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Dirk Proschek, Abstract Co-Author: Nothing to Disclose

Martin G. Mack MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, Abstract Co-Author: Nothing to Disclose

To evaluate the clinical value of a neoadjuvant treatment protocol with repeated transarterial chemoembolization (TACE) before MR-guided laser induced thermotherapy (LITT).

Repeated TACE were performed in 155 patients (mean 4.1 per patient) with unresectable HCC using 10 mg/m2 mitomycin as chemotherapeutic agent and 10 ml/m2 lipiodol and microspheres for vessel occlusion. Of these patients were 48 patients (30,9 %) treated with neoadjuvant intention (the largest lesion smaller than 80 mm in diameter, no more than 5 lesions). After decreasing of the lesions, the patients were treated with MRI-guided LITT 4 to 6 weeks after last embolization. Survival rate of the combined protocol were compared to the results of the patients which were treated only with TACE (n= 123) or with the results of the patients which were treated directly LITT (n= 28).

In the neoadjuvant group repeated TACE enabled a reduction in tumor size in 32 patients (66.7 % of the neoadjuvant group), forming the basis for the performance of MR-guided LITT. In 12 patients, no reduction in tumor size was achieved and in 4 patients disease progression was found, resulting in further TACE treatments or follow-up. The median survival period after the first treatment was 25.0 months for the TACE group, 33.3 months for the LITT group and statistically significant higher with 36.0 months in the patients with the combined treatment.

The combined treatment protocol (MR-guided LITT followed TACE) leads to superior survival rates in comparison to the results of TACE or LITT alone.

Zangos, S, Eichler, K, Lehnert, T, Proschek, D, Mack, M, Vogl, T, Large-sized Hepotocellular Carcinoma (HCC): Neoadjuvant Treatment Protocol with Repetitive Transarterial Chemoembolization (TACE) before MR-guided Laser-induced Thermotherapy (LITT).  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4413856.html