Hepatocellular Carcinoma Clinical Trial
Official title:
Combine Transcatheter Arterial Embolization and Radiofrequency Ablation Versus Transcatheter Arterial Embolization Alone for Hepatocellular Carcinoma With Portal Vein Tumor Thrombus
The purpose of this study is to determine whether combined radiofrequency ablation and transcatheter chemoembolization (TACE) result in better survival outcomes than TACE alone in patients with HCC and portal vein tumor thrombus.
Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second most common
cause of death from cancer globally. Although the development of imaging techniques has
improved early HCC diagnosis, portal vein tumor thrombus (PVTT) is still identified in
12.5-39.7% of HCC patients at their initial visits. Patients suffering from extremely
aggressive HCC with PVTT have a median survival time of only 2.7-4.0 months if left
untreated. The current standard of practice recommends sorafenib, which has been shown to
prolong overall survival (OS) by nearly 3 months in advanced HCC patients and by 1.5-3.2
months in those with PVTT.
Transarterial chemoembolization (TACE) is the main treatment modality for unresectable HCC
patients. Some recent prospective studies have demonstrated that TACE can serve as a safe
and effective procedure in selected HCC patients with PVTT. TACE is recommend for a part of
patients with HCC and PVTT by the treatment guidelines in China and Japan. However,due to
the poor blood supplement of PVTT,the local control rate of PVTT after TACE treatment is
low. Besides,as to some hypovascular intrahepatic tumors, TACE also could not controlled
effectively. As regard to the high local control rate of radiofrequency ablation (RFA) for
intrahepatic lesions and PVTT reported in some studies, we thus suggested that the
combination of TACE and RFA might have higher tumor control rate and survival benefit than
TACE alone.
We design this study to compare survival outcomes of TACE plus RFA and TACE alone in
patients with HCC and PVTT.A total of 240 patients are needed according to statistician's
calculation.They will be divided into two groups randomly by computer after sign the
informed consent form.One group of patients received TACE plus RFA and the other group of
patients received TACE alone.After treatment,patients will be followed-up on their survival,
tumor response and adverse events.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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