First experience of high-intensity focused ultrasound combined with transcatheter arterial embolization as local control for hepatoblastoma

Authors

  • Shan Wang,

    Corresponding author
    1. Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002
    2. Clinical Research Center of Pediatrics, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
    • Address reprint requests to: Prof Shan Wang, Ph.D., 136 Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 P.R. China. E-mail:wangshan778@163.com; fax: +86-23-63622754.

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    • These authors contributed equally.

  • Chao Yang,

    1. Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002
    2. Clinical Research Center of Pediatrics, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
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    • These authors contributed equally.

  • Jun Zhang,

    1. Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002
    2. Clinical Research Center of Pediatrics, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
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  • Xiang-ru Kong,

    1. Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002
    2. Clinical Research Center of Pediatrics, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
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  • Hui Zhu,

    1. Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China
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  • Feng Wu,

    1. Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China
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  • Zhibiao Wang

    1. Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China
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  • Potential conflict of interest: Nothing to report.

Abstract

The purpose of this study was to assess the effectiveness of high-intensity focused ultrasound (HIFU) combined with transarterial chemoembolization (TACE) in treating pediatric hepatoblastoma. Twelve patients with initially unresectable hepatoblastoma were enrolled in the study. All patients received chemotherapy, TACE, and HIFU ablation. Follow-up materials were obtained in all patients. The tumor response, survival rate, and complications were analyzed. Complete ablation was achieved in 10 patients (83.3%), and the alpha-fetoprotein level was also decreased to normal in these patients. The mean follow-up time was 13.3 ± 1.8 months (range, 2-25 months). At the end of follow-up, two patients died from tumor progression, the other 10 patients were alive. One patient was found to have lung metastasis after HIFU and had an operation to remove the lesion. The median survival time was 14 months, and the 1- and 2-year survival rates were 91.7% and 83.3%, respectively. Complications included fever, transient impairment of hepatic function, and mild malformation of ribs. Conclusion: HIFU combined with TACE is a safe and promising method with a low rate of severe complications. As a noninvasive approach, it may provide a novel local therapy for patients with unresectable hepatoblastoma. (Hepatology 2014;58:170–177)

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