经肝动脉插管化疗栓塞术联合射频消融术对比射频消融术治疗复发性肝癌的临床研究  

Clinical study on transaterial chemoembolization combined with radiofrequency ablation versus radiofrequency ablation monotherapy in the treatment of recurrent hepatocellular carcinoma

作　　者：朱宇[1] 田银生[1] 葛明刚[1] 

机构地区：[1]四川省遂宁市中心医院肝胆外科,629000

出　　处：《临床外科杂志》2014年第3期163-166,共4页Journal of Clinical Surgery

摘　　要：目的 探讨经肝动脉插管化疗栓塞术联合射频消融术（transaterial chemoembolization＋radiofrequency ablation,TACE＋RFA）与射频消融术（RFA）对比治疗复发性肝癌的有效性和安全性.方法 回顾性分析本研究中心2005年1月至2012年12月期间122例符合米兰标准的复发性肝癌并接受TACE＋RFA（66例）或RFA（56例）治疗患者的临床资料.结果 TACE＋RFA组患者的1、2、3、4、5年生存率分别为88.4%、72.4%、45.2%、35.2%、10.6%,RFA组分别为84.9%、59.2%、21.3%、14.2%、7.1%,风险比（hazard ratio,HR）（RFA vs TACE＋RFA）：1.69,95%置信区间（confidence interval,CI）：1.05,2.71,P=0.030.TACE＋RFA组1、2年无瘤生存率分别为52.4%、10.0%,而RFA组分别为36.3%、6.7%,HR：1.55,95% CI：1.03,2.34,P=0.035.两组患者在围手术期并发症差异无统计学意义（P=0.859）.单因素和多因素分析显示患者肿瘤复发时间的早晚与患者的预后密切相关.结论 对于符合米兰标准的复发性肝癌患者,TACE＋RFA的序贯治疗优于RFA单一治疗.肿瘤分化程度的高低以及复发时间的早晚与患者的预后密切相关.Objective To evaluate the efficacy and safety of transaterial chemoembolization（TA- CE） combined with radiofrequency ablation （ RFA ） in the treatment of recurrent hepatocellular carcinoma （HCC）. Methods Patients with recurrent HCC conforming Milan criteria who received the treatment of TACE plus RFA （ 66 cases） or RFA monotherapy（56 cases） in our single center during Jan. 2005 to Dec. 2012 were retrospectively analyzed. Results The survival rates of 1,2,3,4,and 5 years were 88.4% , 72.4 %, 45.2 % , 35.2 % , 10.6 % in combined therapy group, respectively, and 84.9 %, 59.2 % , 21.3 % , 14.2% ,7.1% in RFA group, respectively. There was significant difference of survival rates between the two groups [ hazard ratio （ HR ） ： 1.69,95% confidence interval （ CI ） ： 1.05-2.71, P = 0.030 ） ]. The tumor-free survival rates of 1 and 2 years in combined therapy group（52.4% , 10.0% ）were higher than those in the RFA group（ 36.3 % ,6.7% ） （ HR ： 1.55,95% CI ： 1.03-2.34, P = 0. 035 ）. The complication rates in the perioperative period were not significantly different between the two groups （P = 0. 859）. Coilclusion TACE combined with RFA is superior to RFA monotherapy with respect to the overall survival and tumor-free survival of patients with recurrent HCC meeting Milan criteria. The differentiation degree and recurrence interval of carcinoma is correlated with the prognosis of patients.

关 键 词：复发性肝癌 射频消融术 经肝动脉插管化疗栓塞术 临床研究 

分 类 号：R735.7[医药卫生—肿瘤]