探讨经皮射频消融联合肝动脉化学栓塞治疗大肝癌的临床应用效果  

Clinical application of a combination therapy of percutaneous radiofrequency and transcatheter arterial chemoembolization in large hepatic tumors

作　　者：沈理[1] 陈敏华[1] 严昆[1] 杨薇[1] 高文[1] 廖盛日[1] 杨仁杰[2] 

机构地区：[1]北京大学临床肿瘤学院超声科,100036 [2]北京大学临床肿瘤学院介入科,100036

出　　处：《中华超声影像学杂志》2004年第8期577-580,共4页Chinese Journal of Ultrasonography

基　　金：首都医学发展基金项目 (ZD 1 9990 9);"2 1 1"工程肿瘤学科项目 (52 3)

摘　　要：目的　探讨射频消融 (RFA)联合经导管动脉化学栓塞 (TACE)治疗大肝癌的临床应用价值。方法　 62例原发性肝癌患者 ,2 1例行RFA联合TACE治疗 (综合组 ) ,与 2 2例单纯TACE治疗及 19例单纯RFA治疗组进行对照分析。肿瘤最大径 5 .0～ 8.1cm ,平均 ( 5 .9± 0 .7)cm ,计 10 6个肿瘤 ,多发病灶者选其中最大径肿瘤为观察目标。 3组病例的平均年龄、病灶大小以及肝功能分级差异无显著性意义。结果综合组的肿瘤坏死率达 80 .9% ,明显高于单纯TACE组及单纯RFA组 (分别为 2 7.2 %、47.4% ,P <0 .0 5 )。局部复发率分别为 2 3 .8%、45 .5 %和 3 6.8% ,三者差异无显著性意义 (P >0 .0 5 )。综合组的平均生存期为 2 5 .6月 ,高于TACE组 ( 14 .9月 ,P <0 .0 5 ) ,与单纯RFA组 ( 2 0 .1月 )差异无显著性意义 (P >0 .0 5 )。结论　RFA联合TACE治疗大肝癌与单纯TACE和单纯RFA组治疗结果相比 。Objective To investigate the clinical role of a combination therapy of percutaneous radiofrequency ablation(RFA) and transcatheter arterial chemoembolization(TACE) in large hepatic tumors. Methods Out of 62 patients with hepatocellular carcinomas confirmed by pathology, 21 patients received a combination therapy of TACE and RFA(combination group), 22 patients TACE therapy alone, and the rest 19 patients RFA therapy alone. A total of 106 tumors with a mean diameter of ( 5.9± 0.7) cm(ranged from 5.0 to 8.1 cm) were detected, and the largest tumor was selected for observation in a patient with multiple lesions. There was no significant difference in mean age, tumor size and liver function grade among the three groups.Results Tumor complete necrosis accounted for 80.9%in combination group, which was significantly higher than that of TACE group and RFA group ( 27.2%, 47.4%,P< 0.05). Tumor local recurrence was 23.8%, 45.5%, and 36.8% respectively in the combination group, TACE group, and RFA group, and there was no significant difference among the three groups(P> 0.05). Mean survival duration of combination group was 25.6 months, significantly higher than that of TACE group( 14.9 months)(P< 0.05), and similar to that of RFA group( 20.1 months)(P>0.05). Conclusions Compared with TACE or RFA therapy alone, the combination therapy improves tumor complete necrosis rate and prolongs the patients′ survival duration.

关 键 词：射频消融 肝动脉化学栓塞 联合治疗 大肝癌 导管 

分 类 号：R735.7[医药卫生—肿瘤]