Purpose: The objective of our study was to compare the effectiveness of the combination of transcatheter arterial chemoembolization(TACE) and radiofrequency ablation(RFA) with that of surgical resection(SR) in Barcelo...Purpose: The objective of our study was to compare the effectiveness of the combination of transcatheter arterial chemoembolization(TACE) and radiofrequency ablation(RFA) with that of surgical resection(SR) in Barcelona-Clinic Liver Cancer(BCLC) A hepatocellular carcinoma. Materials and Methods: PubMed, Medline, Embase, and Cochrane Library were searched for comparisons of the two therapies from January 2006 to December 2017. Overall survival rate(OS), recurrence-free survival rate(RFS), complications, and the average length of hospital stay were compared and analyzed. Review Manager v. 5.2 from the Cochrane Collaboration was used for statistical analyses. Results: Seven case-control studies and one randomized controlled trial were identified, of which 717 were treated with a combination of TACE and RFA and 785 were treated with SR. Meta-analysis data revealed that TACE plus RFA had significantly better effectiveness on 1.0-y OS(OR = 0.50, p =.009). The major complications(ORcomplications = 1.88, p =.02) after the combined therapy were significantly lower than those after SR. There were three studies that reported the average length of hospital stay. The hospital stay for the SR group vs the combined therapy group was 19.8 ± 8.4 d vs 7.4 ± 2.2 d, respectively(p <.0001); 18.7 ± 4.9 d vs 11.5 ± 6.9 d, respectively(p <.0001); and 16.6 ± 6.7 d vs 8.5 ± 4.1 d, respectively(p <.0001). There was no significant difference in 3.0-or 5.0-y OS and 1.0-, 3.0-, or 5.0-y RFS. Conclusion: The combination of TACE and RFA has advantages in improving 1.0-y OS, reducing complications, and shortening the length of hospital stay over that of SR in the treatment of patients with BCLC A HCC.展开更多
Objectives:To preliminarily evaluate the clinical effectiveness and safety of computed tomography(CT)imageguided irreversible electroporation(IRE)for the treatment of recurrent hepatocellular carcinoma(HCC)after surgi...Objectives:To preliminarily evaluate the clinical effectiveness and safety of computed tomography(CT)imageguided irreversible electroporation(IRE)for the treatment of recurrent hepatocellular carcinoma(HCC)after surgical resection.Methods:From January 2016 to February 2018,18 patients diagnosed with recurrent HCC after surgical resection received IRE under CT image guidance for 22 tumors.Patients were enrolled for IRE when ineligible for thermal ablation due to tumor location.Clinical records and imaging data were reviewed to assess complete ablation rate,local tumor progression free rate(LTPFR),local tumor progression free survival(LTPFS)and complications after a median follow-up time of 14 months.Results:Successful complete ablations were achieved in 20/22(90.1%)tumors.Mean LTPFS was 10.5?9.4 months.Overall 3-,6-and 12-months LTPFR in 22 tumors following IRE were 68.2%(95%confidence interval[CI]:45%–83%),59.1%(95%CI:33%–76%)and 36.4%(95%CI:17%–56%),respectively.Complications included pneumothorax(2/18,11.1%),localized pain(3/18,16.7%),bile duct dilation(1/18,5.6%)and transient hypertension(1/18,5.6%).No major complications or treatment-related deaths were observed.The alphafetoprotein levels of two patients decreased to the normal range at 3 and 4 months,respectively.Conclusions:This study showed that percutaneous CT image-guided IRE can serve as a safe and effective treatment for recurrent HCC not suitable for thermal ablation.展开更多
Ballistic Missile Trajectory Prediction(BMTP)is critical to air defense systems.Most Trajectory Prediction(TP)methods focus on the coast and reentry phases,in which the Ballistic Missile(BM)trajectories are modeled as...Ballistic Missile Trajectory Prediction(BMTP)is critical to air defense systems.Most Trajectory Prediction(TP)methods focus on the coast and reentry phases,in which the Ballistic Missile(BM)trajectories are modeled as ellipses or the state components are propagated by the dynamic integral equations on time scales.In contrast,the boost-phase TP is more challenging because there are many unknown forces acting on the BM in this phase.To tackle this difficult problem,a novel BMTP method by using Gaussian Processes(GPs)is proposed in this paper.In particular,the GP is employed to train the prediction error model of the boost-phase trajectory database,in which the error refers to the difference between the true BM state at the prediction moment and the integral extrapolation of the BM state.And the final BMTP is a combination of the dynamic equation based numerical integration and the GP-based prediction error.Since the trained GP aims to capture the relationship between the numerical integration and the unknown error,the modified BM state prediction is closer to the true one compared with the original TP.Furthermore,the GP is able to output the uncertainty information of the TP,which is of great significance for determining the warning range centered on the predicted BM state.Simulation results show that the proposed method effectively improves the BMTP accuracy during the boost phase and provides reliable uncertainty estimation boundaries.展开更多
文摘Purpose: The objective of our study was to compare the effectiveness of the combination of transcatheter arterial chemoembolization(TACE) and radiofrequency ablation(RFA) with that of surgical resection(SR) in Barcelona-Clinic Liver Cancer(BCLC) A hepatocellular carcinoma. Materials and Methods: PubMed, Medline, Embase, and Cochrane Library were searched for comparisons of the two therapies from January 2006 to December 2017. Overall survival rate(OS), recurrence-free survival rate(RFS), complications, and the average length of hospital stay were compared and analyzed. Review Manager v. 5.2 from the Cochrane Collaboration was used for statistical analyses. Results: Seven case-control studies and one randomized controlled trial were identified, of which 717 were treated with a combination of TACE and RFA and 785 were treated with SR. Meta-analysis data revealed that TACE plus RFA had significantly better effectiveness on 1.0-y OS(OR = 0.50, p =.009). The major complications(ORcomplications = 1.88, p =.02) after the combined therapy were significantly lower than those after SR. There were three studies that reported the average length of hospital stay. The hospital stay for the SR group vs the combined therapy group was 19.8 ± 8.4 d vs 7.4 ± 2.2 d, respectively(p <.0001); 18.7 ± 4.9 d vs 11.5 ± 6.9 d, respectively(p <.0001); and 16.6 ± 6.7 d vs 8.5 ± 4.1 d, respectively(p <.0001). There was no significant difference in 3.0-or 5.0-y OS and 1.0-, 3.0-, or 5.0-y RFS. Conclusion: The combination of TACE and RFA has advantages in improving 1.0-y OS, reducing complications, and shortening the length of hospital stay over that of SR in the treatment of patients with BCLC A HCC.
文摘Objectives:To preliminarily evaluate the clinical effectiveness and safety of computed tomography(CT)imageguided irreversible electroporation(IRE)for the treatment of recurrent hepatocellular carcinoma(HCC)after surgical resection.Methods:From January 2016 to February 2018,18 patients diagnosed with recurrent HCC after surgical resection received IRE under CT image guidance for 22 tumors.Patients were enrolled for IRE when ineligible for thermal ablation due to tumor location.Clinical records and imaging data were reviewed to assess complete ablation rate,local tumor progression free rate(LTPFR),local tumor progression free survival(LTPFS)and complications after a median follow-up time of 14 months.Results:Successful complete ablations were achieved in 20/22(90.1%)tumors.Mean LTPFS was 10.5?9.4 months.Overall 3-,6-and 12-months LTPFR in 22 tumors following IRE were 68.2%(95%confidence interval[CI]:45%–83%),59.1%(95%CI:33%–76%)and 36.4%(95%CI:17%–56%),respectively.Complications included pneumothorax(2/18,11.1%),localized pain(3/18,16.7%),bile duct dilation(1/18,5.6%)and transient hypertension(1/18,5.6%).No major complications or treatment-related deaths were observed.The alphafetoprotein levels of two patients decreased to the normal range at 3 and 4 months,respectively.Conclusions:This study showed that percutaneous CT image-guided IRE can serve as a safe and effective treatment for recurrent HCC not suitable for thermal ablation.
基金support from National Natural Science Foundation of China(Nos.61873205,61771399)Aerospace Science Foundation of China(No.2019-HT-XGD)Natural Science Basic Research Plan in Shaanxi Province of China(No.2020JM-101).
文摘Ballistic Missile Trajectory Prediction(BMTP)is critical to air defense systems.Most Trajectory Prediction(TP)methods focus on the coast and reentry phases,in which the Ballistic Missile(BM)trajectories are modeled as ellipses or the state components are propagated by the dynamic integral equations on time scales.In contrast,the boost-phase TP is more challenging because there are many unknown forces acting on the BM in this phase.To tackle this difficult problem,a novel BMTP method by using Gaussian Processes(GPs)is proposed in this paper.In particular,the GP is employed to train the prediction error model of the boost-phase trajectory database,in which the error refers to the difference between the true BM state at the prediction moment and the integral extrapolation of the BM state.And the final BMTP is a combination of the dynamic equation based numerical integration and the GP-based prediction error.Since the trained GP aims to capture the relationship between the numerical integration and the unknown error,the modified BM state prediction is closer to the true one compared with the original TP.Furthermore,the GP is able to output the uncertainty information of the TP,which is of great significance for determining the warning range centered on the predicted BM state.Simulation results show that the proposed method effectively improves the BMTP accuracy during the boost phase and provides reliable uncertainty estimation boundaries.
