Liver cancer including primary hepatocellular carcinoma (HCC) and metastatic liver cancers is one the most common malignancies in the world. Over 10000 new cases per year are diagnosed in Taiwan. Despite the many treatment options, the prognosis of HCC remains dismal. More than 8000 people died of this cancer every year in Taiwan. A majority (70% to 85%) of patients present with advanced or unresectable disease. In contrast, small liver cancers can be cured with an appreciable frequency. Five-year disease-free survival exceeding 50% has been reported for surgical resection, and for the inoperable patients who do not have vascular invasion or extrahepatic spread. Radiofrequency ablation (RFA) is recommended as an alternative curative therapy. However, the main drawback of RFA is its limitation to tumor size and location. The tumors larger than 5 cm in diameter or located adjacent to vessels, could not be ablated completely sometimes.
Irreversible electroporation (IRE), developed and manufactured by AngioDynamics US Ltd, can ablate tumor by fenestrating the cancer cell membrane by electric pulse. The anti-tumor effect does not result from thermotherapy, so is also not diminished by adjacent vessels. Several pre-clinical studies have already demonstrated IRE is a safe and effective treatment for live cancers. The system has been approved as safe by the European Union (EU) in 2008 and received Food and Drug Administration (FDA) approval in 2010. However, there are still few experiences in using IRE for tumor ablation in Taiwan. In this study, the investigators will perform IRE for 40 inoperable patients with liver cancers adjacent to vessels who are suitable to receive radiofrequency ablation (RFA) in the investigators hospital. The investigators will evaluate the potential side effect and ablate effect of tumors by abdominal computed tomography (CT) or magnetic resonance imaging (MRI), and the investigators will also follow-up this patients for 2 years to evaluate the overall survival and local recurrence rate. The investigators will appraisal the clinical feasibility and advantage of the system by this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
National Taiwan University Hospital
Taipei, Taiwan
Tumor response
Tumor response, according to modified RECIST criteria, will be evaluated by abdominal computed tomography (CT) or magnetic resonance imaging (MRI) 1 month after treatment.
Time frame: 1 month after treatment
Change of Eastern Cooperative Oncology Group (ECOG) evaluation
Complete an Eastern Cooperative Oncology Group (ECOG) evaluation
Time frame: one to two years
Change of vital signs
Measure vital signs including temperature, respiratory rate, blood pressure, and heart rate.
Time frame: one to two years
Physical examination
Conduct a physical examination.
Time frame: one to two years
Clinical laboratory assessments
Collect blood samples for Clinical laboratory assessments, including hematology, A-fetoprotein (AFP) (for hepatocellular carcinoma (HCC)) / carcinoembryonic antigen (CEA) (for adenocarcinoma) and chemistry evaluations.
Time frame: one to two years
Urinalysis
Collect urine sample for a routine urinalysis.
Time frame: one to two years
Conduct CT or MR scans for tumour response evaluation
Subjects will still be followed-up in the event of disease progression in order to document local recurrence, a secondary endpoint.
Time frame: one to two years
Review concomitant medications
Use of medications will be reviewed and recorded.
Time frame: one to two years
Assess for presence of adverse events
An adverse event assessment will be performed.
Time frame: one to two years
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