Hepatocellular Carcinoma
Pat Price, Karol Sikora in Treatment of Cancer, 2020
Image-guided ablation is regarded as the best therapeutic option for patients with small HCC not suitable for resection or transplantation. Treatment is usually performed percutaneously under ultrasound or CT guidance. Several methods for tumor destruction have been used, the most widely studied being percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA). The injection of 90 per cent ethanol under ultrasound guidance is technically straightforward, inexpensive, safe, and results in 5-year survival of 50 per cent in Child A, 30 per cent in Child B, but less than 10 per cent in Child C cirrhotics.49 Complete tumor necrosis is achieved in 70 per cent of tumors less than 3 cm in diameter, but this falls with increasing size (50 per cent in lesions 3–5 cm), probably due to the inability of the injected volume to disperse evenly throughout larger tumors that may contain fibrous septae. Radiofrequency ablation is a localized thermal treatment producing tumor destruction by heating a probe inserted into the tumor to temperatures exceeding 50°C, which can be performed percutaneously under image guidance, laparoscopically or at laparotomy.
Innovations and Future Prospects of Dermal Delivery Systems
Tapash K. Ghosh in Dermal Drug Delivery, 2020
Apart from microneedles, other technologies involving thermal energy, laser or radiofrequency ablation and ultrasound are also being developed to enable microporation. Thermal microporation utilizes short high temperature pulses to cause structural disruption and vaporization of stratum corneum to create temporary micropores/micron-sized channels in the skin. A single disposable patch based on this patented technology (PassPort®) is being developed by Nitto Denko. Radiofrequency ablation is similar to thermal microporation technology; it utilizes electrical current in the radiofrequency range (100–500 KHz) applied to an array of microelectrodes to cause ionic vibration in the skin cells, leading to localized heating and cell ablation. A parathyroid hormone patch based on this technology was developed; but was not able to achieve the primary endpoint in phase II clinical trials.
Clinicians' Perspective in the Use and Adaptability of the Latest Methods of Diagnosis and Treatment for Cancers in Women
Shazia Rashid, Ankur Saxena, Sabia Rashid in Latest Advances in Diagnosis and Treatment of Women-Associated Cancers, 2022
Thermal ablation and magnetic hyperthermia are currently used in treating neoplastic tissues. Thermal ablation uses a temperature lower than −40°C or higher than 60°C for long exposure to damage a tumour cell. Hypothermic ablation occurs due to the formation of ice crystals upon cooling, which destroys cell membranes and kills cells. Radiofrequency ablation (RF ablation) is the most popular in clinics because of its efficacy and safety. It uses an alternative current of RF waves to a target zone by an insulated electrode tip and the interaction of the current causes the oscillation of ions in the extracellular fluid which produces heat. Ablation of the T-zone with cryotherapy has been highly successful in curing cervical cancers, as has been reported in a recent Cochrane systematic review, which reports the rate of success in cryotherapy to treat CIN 3 lesions up to 93% [18]. Magnetic hyperthermia is another new way to heat tumour tissues which exploits superparamagnetic or ferromagnetic nanoparticles capable of generating heat after stimulation with an alternating magnetic field [19].
The blood cells in NSCLC and the changes after RFA
Published in International Journal of Hyperthermia, 2020
Yunfang Li, Dongdong Wang, Xiaoguang Li
Besides cancer cells, solid tumors also contain interstitial tissues composed of nonmalignant cells, such as fibroblasts, homing epithelial cells, pericytes, myofibroblasts, vascular endothelial cells, lymphatic endothelial cells, and infiltrating immune cells. These cells together constitute the tumor microenvironment. Radiofrequency ablation is one of the earliest and most mature techniques of percutaneous tumor ablation, which has a history of clinical application and has been used for over 40 years. It is also a hyperthermia method provided over lethal temperatures. After ablation treatment, tumor tissue becomes coagulative necrosis and remains in the body Meanwhile, the tumor microenvironment and the immune state of the body change, which can stimulate the body to produce anti-tumor immune effect [7].
Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
Published in International Journal of Hyperthermia, 2021
Benedetto Ielpo, Eva M. Pueyo-Périz, Aleksandar Radosevic, Anna Andaluz, Enrique Berjano, Luis Grande, Patricia Sánchez-Velázquez, Fernando Burdío
Endolumnal thermal ablation (ETHA) of the main pancreatic duct was performed by the off-label use of the ClosureFast system (Medtronic, Mansfield, MA, USA), originally designed to treat varicose veins [8]. The ClosureFast applicator consists of a 7 F catheter with a coil on its surface which is heated by the passage of RF current through the coil itself [9]. This means that no electrical RF current flows into the tissue and heat is applied only to the tissue surrounding the device, so that the term “radiofrequency ablation” applied to the ClosureFast system may be confusing. In both clinical cases several overlapped 60-s applications were applied to the main pancreatic duct programming a target temperature of 120 °C (see video in supplementary material). The catheter was fully inserted through the pancreatic duct and slowly withdrawn during the double heating cycles (see Figure 1(a)), as in treating varicose veins, avoiding ablation over the last proximal centimeter. After completing the ablation zone around the main pancreatic duct, a pancreatico-enteric anastomosis was conducted (see Figure 1(b)).
Evaluation of percutaneous adhesiolysis for the management of chronic pain due to post spine surgery syndrome
Published in Egyptian Journal of Anaesthesia, 2023
Salah Mostafa Asida, Saeid Elsawy, Mahmoud Faisal, Ossama Hamdy
Minimally invasive procedures are another line for treatment; it includes epidural steroid injections (ESIs) and epidural injections, these two procedures are the most performed surgery in pain clinics worldwide [5]. There are three primary approaches for administering treatments for radiculopathy; transforaminal, interlaminar or caudally. Radiofrequency ablation is often used to produce long-lasting relief that diagnostic blocks or injections cannot achieve. Spinal cord stimulation has shown potential in managing FBSS. Lysis of adhesions can improve baseline pain scores and drug delivery of ESI, which is done by the delivery of hyaluronidase combined with hypertonic saline into the epidural space. Combining hyaluronidase with steroid may be more efficient and have linger impact than either one solely.
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