The Efficacy And Safety Of Hifu For Liver Cancer With The Aid Of Artificial Pleural Fluid

Background:Liver cancer is the second most common cancer after lung cancer inChina, about600,000new cases are diagnosed each year. Although thesurgery is still the treatment of choice, only about20%of the patients areindicated for surgery when the diagnosis is made. For patients who are notindicated or do not want to have surgery, the non-surgical treatments such ashigh-intensity focused ultrasound (HIFU), radiofrequency ablation (RAF),or microwave coagulation(MC) have been the choices. But for the tumorslocate close to the diaphragm, due to the lungs and diaphragm, it is difficultto treat with these techniques.Objective：1. To evaluate the role of artificial pleural effusion in HIFU treatmentof liver tumors close to the diaphragm;2. To evaluate the safety of HIFU for liver cancer with the aid ofartificial pleural effussion.Methods：From March2013to March2014,54patients from the department of tumor therapeutic center of the second affiliated hospital of chongqingmedical university were reviewed. All of the tumor lesions were locatednear the diaphragm. Different volume of0.9%of normal saline wasinjected into pleural cavity before HIFU treatment. Electrocardiogram(ECG), heart rate (HR), mean arterial pressure (MAP), transcutaneousoxygen saturation (SpO2), and end-tidal carbon dioxide partial pressure(PETCO2) were monitored; MRI was used to evaluate the treatmentresults.ResultsHIFU treatment was successfully performed in53of54(98.1%)patients. Among them, the lungs were successfully push away in51of54(94.4%) patients after injection of less than600ml of normal saline, whilethe guided ultrasound monitor show a clear image of the lesions. The ECG,HR, MAP, and SpO2remained stable during the treatment, PETCO2increased after the injection of artificial pleural effusion, but still within asafe range. In two weeks, the artificial pleural effusion disappeared in64.8%(35/54). The pneumothorax or liquid pneumothorax occurred in7.4%of the patients, no other major complications were observed.Conclusions：HIFU for liver cancer with the aid of artificial pleural fluid is efficacyand safety.