Radiofrequency Ablation Duration per Tumor Volume May Correlate with Overall Survival in Solitary Hepatocellular Carcinoma Patients Treated with RF Ablation Plus Lyso-thermosensitive Liposomal Doxorubicin.

Abstract

PURPOSE\nTo determine whether burn time per tumor volume (BPV) (min/mL), where burn time is the total time during which radiofrequency (RF) energy is being applied, is correlated with hepatocellular carcinoma (HCC) treatment outcomes using RF ablation and lyso-thermosensitive liposomal doxorubicin (LTLD).\n\n\nMATERIALS AND METHODS\nThe HEAT study was a double-blind, randomized controlled phase III trial of RF ablation only versus RF ablation\xa0+ LTLD in patients with HCCs 3-7 cm in diameter. Effect of BPV on progression-free survival and overall survival (OS) was analyzed.\n\n\nRESULTS\nBPV demonstrated statistically significant differences between study groups for OS (P\xa0= .038, hazard ratio [HR]\xa0= 0.85), but not for progression-free survival (P\xa0= .389, HR\xa0= 1.059). In a separate analysis, treatment groups were independently analyzed to determine the effect of BPV within each individual group. OS improved as BPV increased for patients receiving RF ablation\xa0+ LTLD (P\xa0= .017, HR\xa0= 0.836, confidence interval [0.722, 0.968]). This same association was not observed in patients receiving RF ablation only (P\xa0= .57, HR\xa0= 0.99).\n\n\nCONCLUSIONS\nBPV may be a useful metric for RF ablation\xa0+ LTLD combination therapy for solitary HCC. The analysis suggested that the burn time for the tumor needs to be adjusted depending on the tumor volume. Because this is a post hoc study, the results are only suggestive and need to be confirmed with prospective studies.