射频消融联合肝动脉栓塞化疗治疗肝细胞癌96例报告  

Clinical efficacy and reliability of percutaneous radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma： A report of 96 cases

作　　者：张建平[1] 倪家连[1] 郑宝珍[1] 

机构地区：[1]济南军区总医院肝胆外科,济南250031

出　　处：《腹部外科》2011年第6期350-352,共3页Journal of Abdominal Surgery

摘　　要：目的探讨肝细胞癌经皮射频消融（PRFA）联合肝动脉栓塞化疗（TACE）的治疗效果、评价及其安全性。方法回顾性分析96例采用经皮RFA联合TACE治疗的肝细胞癌病人的临床资料，比较联合治疗前、后血清甲胎蛋白（AFP）水平及阳性率变化，计算治疗后1、2、3年的累积生存率，观察联合治疗后近期并发症及远期死亡原因。结果治疗前AFP平均（369．6±76．8）μg／L，阳性率为74．0％；治疗后AFP平均（81．2±33．6）μg／L，阳性率为36．5％；治疗前、后AFP数值变化及阳性率比较，差异均有统计学意义（P〈0．01）。治疗后肿瘤完全坏死率为53．1％（51／96），治疗有效率为87．5％（84／96），1、2、3年累积生存率分别为87．6％、51．3％和29．1％。仅1例近期发生肝功能衰竭死亡病例。结论PRFA联合TACE是一种安全、有效的治疗方法。若病人肝功能代偿良好，应行PRFA和TACE多次序贯治疗。Objective To evaluate the therapeutic efficacy and reliability of percutaneous radiofrequency ablation （PRFA） combined with transcatheter arterial ehemoembolization （TACE） for hepatocellular carcinoma （HCC）. Methods The clinical data of 96 cases of HCC treated with PRFA combined with TACE were analyzed retrospectively, and the levels of serum AFP and its positive rate were compared before and after treatment of PRFA combined With TACE. The 1-, 2- and 3-year survival rate was calculated by Kaplan-Meier method. The complications after PRFA combined with TACE were also observed. Results The serum average level of AFP and its positive rate were （369. 6 ± 76. 8） μg/L and 74. 0% pre-treatment, and those were （81.2 ± 33.6）μg/L and 36. 5% post-treatment respectively. There were significant differences before and after PRFA combined with TACE. The 1-, 2- and 3-year survival rate was 87.6 %, 51.3% and 29. 1%, respectively. One case was died of liver failure after treatment of PRFA combined with TACE. Conclusion The protocol of PRFA combined with TACE is an effective and reliable procedure for HCC. Sequential treatment with PRFA and TACE should be performed if liver function is well compensatory for HCC.

关 键 词：癌 肝细胞 导管消融术 抗肿瘤联合化疗方案 

分 类 号：R735.7[医药卫生—肿瘤]