Radiofrequency Ablation of Hepatic Lesions: A Review

Venkataramu N. Krishnamurthy, MD; V. Javier Casillas, MD; Lina Latorre, MD


Appl Radiol. 2003;32(10) 

In This Article

Combination Therapy of Hepatic Tumors--The Future of RF Ablation?

Complete ablation of hepatic tumor depends not only on a perfect technique, but also on the biology of the tumor itself. There are strategies for combining RF ablation with other minimally invasive techniques, eg, intratumoral chemotherapeutic drug injection and PEI, which can alter the biology of the tumor such that tumor cells become more susceptible to heat.

It has been documented that the chemo-therapeutic agents and hyperthermia (42°C to 45°C) have synergetic effects.[21,22] Goldberg et al[64] demonstrated in an ex-perimental rat model (R3230 mammary adenocarcinoma) that intratumoral injection of doxorubicin increases the volume of coagulation necrosis by RF ablation. The ablation volume was significantly greater than the volume with RF therapy or doxorubicin therapy alone. The extent of coagulation was dependent on both the dose and timing of the doxorubicin, with the greatest coagulation achieved when doxorubicin was administered within 30 minutes of RF ablation. In another experiment (R3230 mammary adenocarcinoma, breast tumor model in rats), Goldberg et al[65] showed that combined therapy consisting of PEI immediately followed by RF ablation showed significant increase in the extent of coagulation necrosis compared with either treatment performed alone. These combined strategies open a new venue for achieving complete tumor ablation of smaller tumors and may make ablation of larger tumors realistic in the future. However, further studies are necessary to determine which combinations are more effective and if they improve long-term outcome.