BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-ol...BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-old man was diagnosed with HCC related to hepatitis B one year ago and underwent surgical tumor resection and tenofovir antiviral treatment.However, a new lesion developed on the right liver after 1 mo. Transarterial chemoembolization was performed four times. One month ago, the patient developed back pain, and metastasis on the 11 th thoracic vertebra was detected.Argon-helium cryoablation was performed to treat the right occupancy and metastatic lesion, which immediately alleviated the pain and prolonged survival.CONCLUSION The use of argon-helium cryoablation for thoracic vertebrae with metastasis of HCC achieved favorable results.展开更多
BACKGROUND The survival of patients treated with monotherapy for hepatic malignancies is not ideal.A comprehensive program of cryoablation combined with radiotherapy for the treatment of hepatic malignancies results i...BACKGROUND The survival of patients treated with monotherapy for hepatic malignancies is not ideal.A comprehensive program of cryoablation combined with radiotherapy for the treatment of hepatic malignancies results in less trauma to the patients.It may provide an option for the treatment of patients with advanced hepatic malignancies.CASE SUMMARY We reported 5 cases of advanced-stage hepatic malignancies treated in our hospital from 2017-2018,including 3 cases of primary hepatocellular carcinoma and 2 cases of metastatic hepatic carcinoma.They first received cryoablation therapy on their liver lesions.The procedure consisted of 2 freeze-thaw cycles,and for each session,the duration of freezing was 13-15 min,and the natural rewarming period was 2-8 min.Depending on the tumor size,the appropriate cryoprobes were selected to achieve complete tumor ablation to the greatest extent possible.After cryoablation surgery,intensity-modulated radiotherapy(IMRT)for liver lesions was performed,and the radiotherapy regimen was 5400 cGy/18f and 300 cGy/f.None of the 5 patients had adverse events above grade II,and their quality of life was significantly improved.Among them,4 patients were free of disease progression in the liver lesions under local control,and their survival was prolonged;3 patients are still alive.CONCLUSION Our clinical practice demonstrated that cryoablation combined with IMRT could be implemented safely.The definitive efficacy for hepatic malignancies needs to be confirmed in larger-size sample prospective studies.展开更多
In the last decade, the treatment of dysplastic Barrett’s esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barr...In the last decade, the treatment of dysplastic Barrett’s esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barrett’s esophagus. One of the newest therapies, cryospray ablation, has become a modality to treat both dysplastic Barrett’s esophagus as well as esophageal carcinoma. In endoscopic applications, the cryogen used is either liquid nitrogen or carbon dioxide which causes tissue destruction through rapid freeze-thaw cycles. Unlike other endoscopic ablation techniques, its unique mechanism of action and depth of tissue injury allow cryoablation to be used effectively in flat or nodular disease. It can be combined with other modalities such as endoscopic mucosal resection or radiofrequency ablation. Its esophageal applications stem well-beyond Barrett’s into ablation of early carcinoma, palliative debulking of advanced carcinoma and reduction of tumor ingrowth into stents placed for dysphagia. Although there are fewer reported studies of endoscopic cryoablation in the literature compared to other endoscopic ablation methods, emerging research continues to demonstrate its efficacy as a durable ablation technology with a variety of applications. The aim of this review is to examine the pathophysiology of endoscopic cryospray ablation, describe its outcomes in Barrett’s with dysplasia and esophageal carcinoma, and examine its role in other gastrointestinal applications such as hemostasis in the stomach and rectum.展开更多
文摘BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-old man was diagnosed with HCC related to hepatitis B one year ago and underwent surgical tumor resection and tenofovir antiviral treatment.However, a new lesion developed on the right liver after 1 mo. Transarterial chemoembolization was performed four times. One month ago, the patient developed back pain, and metastasis on the 11 th thoracic vertebra was detected.Argon-helium cryoablation was performed to treat the right occupancy and metastatic lesion, which immediately alleviated the pain and prolonged survival.CONCLUSION The use of argon-helium cryoablation for thoracic vertebrae with metastasis of HCC achieved favorable results.
基金Supported by Health Commission of Hebei Province,No.G2018068
文摘BACKGROUND The survival of patients treated with monotherapy for hepatic malignancies is not ideal.A comprehensive program of cryoablation combined with radiotherapy for the treatment of hepatic malignancies results in less trauma to the patients.It may provide an option for the treatment of patients with advanced hepatic malignancies.CASE SUMMARY We reported 5 cases of advanced-stage hepatic malignancies treated in our hospital from 2017-2018,including 3 cases of primary hepatocellular carcinoma and 2 cases of metastatic hepatic carcinoma.They first received cryoablation therapy on their liver lesions.The procedure consisted of 2 freeze-thaw cycles,and for each session,the duration of freezing was 13-15 min,and the natural rewarming period was 2-8 min.Depending on the tumor size,the appropriate cryoprobes were selected to achieve complete tumor ablation to the greatest extent possible.After cryoablation surgery,intensity-modulated radiotherapy(IMRT)for liver lesions was performed,and the radiotherapy regimen was 5400 cGy/18f and 300 cGy/f.None of the 5 patients had adverse events above grade II,and their quality of life was significantly improved.Among them,4 patients were free of disease progression in the liver lesions under local control,and their survival was prolonged;3 patients are still alive.CONCLUSION Our clinical practice demonstrated that cryoablation combined with IMRT could be implemented safely.The definitive efficacy for hepatic malignancies needs to be confirmed in larger-size sample prospective studies.
文摘In the last decade, the treatment of dysplastic Barrett’s esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barrett’s esophagus. One of the newest therapies, cryospray ablation, has become a modality to treat both dysplastic Barrett’s esophagus as well as esophageal carcinoma. In endoscopic applications, the cryogen used is either liquid nitrogen or carbon dioxide which causes tissue destruction through rapid freeze-thaw cycles. Unlike other endoscopic ablation techniques, its unique mechanism of action and depth of tissue injury allow cryoablation to be used effectively in flat or nodular disease. It can be combined with other modalities such as endoscopic mucosal resection or radiofrequency ablation. Its esophageal applications stem well-beyond Barrett’s into ablation of early carcinoma, palliative debulking of advanced carcinoma and reduction of tumor ingrowth into stents placed for dysphagia. Although there are fewer reported studies of endoscopic cryoablation in the literature compared to other endoscopic ablation methods, emerging research continues to demonstrate its efficacy as a durable ablation technology with a variety of applications. The aim of this review is to examine the pathophysiology of endoscopic cryospray ablation, describe its outcomes in Barrett’s with dysplasia and esophageal carcinoma, and examine its role in other gastrointestinal applications such as hemostasis in the stomach and rectum.
