RFA safe for treating liver tumors pushing on GI tract; Alcohol injection makes RFA more effective

Radiofrequency ablation (RFA), the use of electrodes to heat and destroy abnormal tissue, is a safe and effective treatment for eradicating liver tumors that are in contact with the gastrointestinal (GI) tract, says one study in the November 2004 issue of the American Journal of Roentgenology, while a separate study in that same issue says that RFA becomes even more effective when alcohol is injected into a liver tumor before an RFA procedure.

In the first study, researchers from the Samsung Medical Center in Seoul, South Korea, analyzed 41 patients who each had a liver tumor abutting the GI tract. RFA was performed on these patients and, upon follow-up, 34 of the 41 tumors were found to be eradicated, with no bowel-related complications occurring in any of the 41 patients.

According to Hyo K. Lim, MD, one of the authors of the study, RFA is considered a safe treatment for liver tumors, but investigators have warned against injuries that might occur when the tumors are touching the GI tract. “Many investigators have cautioned that RFA of tumors abutting the bowel could result in collateral thermal damage to the bowel. Also, there is potential for the tines of the electrode to perforate the bowel.” According to the study’s results, however, this isn’t the case, said Dr. Lim.

In a separate study, researchers from Brigham and Women’s Hospital in Boston, MA, found that injecting alcohol into a liver tumor immediately prior to RFA makes the RFA procedure more effective.

For that study, the researchers compared one group of patients who underwent RFA alone to a second group who underwent a combination of RFA and alcohol injection. The researchers found that by adding alcohol injections to RFA, more of the tumor was destroyed with each treatment, so patients had to undergo fewer RFA treatments. “These results suggest that the combination could lead to more effective treatment of liver tumors, particularly with large tumors,” said Sridhar Shankar, MD, lead author of the study, who is currently at the University of Massachusetts, Worcester.

According to the researchers, the combination of alcohol injection and RFA is also effective in tumors in other parts of the body, as well. “We have used the combination therapy successfully in other parts of the body, such as with bone and soft-tissue tumors. However, the combination must be used carefully in areas where alcohol leakage could be deleterious, such as in the lung where normal tissue may be affected,” said Dr. Shankar.