High intensity focused ultrasound therapy: a new treatment on the horizon for hepatocellular carcinoma

Abstract

BACKGROUND: High intensity focused ultrasound (HIFU) therapy has emerged to be a new and innovative loco-regional treatment for hepatocellular carcinoma (HCC) in recent years. It is an extracorporeal conformal therapy. By targeting a high intensity ultrasound beam at a focal point within the tumor, hyperthermia is induced leading to coagulation necrosis of the tumor cells. We herein report our experience in its clinical application for treatment of recurrent HCC. METHODS: From October 2006 to October 2009, 27 patients received HIFU therapy for recurrent HCC in our center. Their postoperative and survival outcomes were compared with 76 patients who received radiofrequency ablation (RFA) within the same period. P value < 0.05 was considered to be significant. RESULTS: The median age of patients receiving HIFU and RFA was 63 and 62 years old respectively. There was no difference in the frequency of co-morbid illness and hepatitis B positivity between the two groups. The median tumor size in HIFU and RFA group was 1.8 and 1.7 cm respectively (P = 0.28). Operative morbidity rate in the HIFU and RFA group was 7.4 and 22.4% respectively (P = 0.06). Skin burn and liver abscess were the two complications associated with HIFU therapy. There was no hospital mortality in the HIFU group while two deaths were observed in the RFA group. The 1-, 2- and 3-year tumor-free survival rates for HIFU group were 33.3, 22.2 and 0%, respectively, and for RFA group were 26.9, 0, 0%, respectively (P = 0.22). The 1-, 2- and 3-year overall survival rates for HIFU group were 100, 100 and 85.7%, respectively, and for RFA group were 89.1, 71.9 and 62.7%, respectively (P = 0.19). CONCLUSION: Our preliminary experience in utilizing HIFU therapy for treatment of recurrent HCC is promising. Further studies are needed to define its role as a primary treatment of HCC.