Study of the enhancing effect of sodium chloride injection on radiofrequency ablation of hepatocellular carcinoma
- Citation:
- Kady, N. E., E. Hasan, G. Esmat, M. M. Nabeel, S. Hamdy, A. Fouad, D. Omran, S. Darweesh, and H. Khattab, Study of the enhancing effect of sodium chloride injection on radiofrequency ablation of hepatocellular carcinoma, , 2009.
Abstract:
Background and study aims: One of the potential strategies to increase the efficacy of RFA is to modulate
the biologic environment of the treated tissues. Several investigators have studied increasing RFA heating
by combining intra-tumoral injections of different concentrations of sodium chloride with RFA. The aim
of this study is to assess the enhancing effect of normal saline (NS) on radiofrequency ablation (RFA) of
hepatocellular carcinoma (HCC) using a cool-tip needle.
Patients and methods: This study included 40 patients with HCC (proved by histopathology or combined
spiral CT and elevated alpha-fetoprotein). They were randomly divided into two groups (20 patients in
each group). The first group was treated with RFA preceded by intra-tumoral normal saline injection
(RFA + S); the second group was treated with RFA only (RFA).
Results: The procedure was successful in all patients (100%) of the RFA + S group and in 11 (55%) of the
RFA group (as proved by spiral CT or pathology). This difference between the two procedures was statistically
highly significant (P = <0.01). No major complications occurred in either group.
Conclusions: Combined RFA and normal saline is more effective than RFA alone. Considering the reduced
cost and wide availability of isotonic saline together with the easy performance of the intra-tumoral
injection, the dramatic improvement in therapeutic effect of RFA to 100% could be a breakthrough in
future strategies to modernize the RFA technique.