TACE联合多影像引导技术精准消融特殊部位肝细胞癌29例  

TACE combined with precision radiofrequency ablation by using multiple imaging guidance technology for HCC located at exceptional sites

作　　者：杨柏帅[1] 袁敏[1] 侯毅斌 周粟[1] 李清涛[1] 陈天佑[1] YANG Boshuai;YUAN Min;HOU Yibin;ZHOU Su;LI Qingtao;CHEN Tianyou(Department of Interventional Radiology, Shanghai Public Health Center Affiliated to Fudan University, Shanghai 201508, China)

机构地区：[1]复旦大学附属上海公共卫生中心介入放射科,上海201508

出　　处：《介入放射学杂志》2018年第12期1193-1198,共6页Journal of Interventional Radiology

摘　　要：目的探讨肝动脉化疗栓塞术(TACE)联合多影像引导技术精准RFA特殊部位肝癌的可行性、有效性及安全性。方法回顾性分析2013年4月至2017年5月行TACE联合RFA治疗98例肝细胞肝癌(HCC)患者,其中常规部位病灶消融69例、特殊部位病灶消融29例,所有患者术前术后均行增强CT或MRI及实验室检查,随访并比较两组患者的肿瘤完全坏死率、生存率、生存时间、肿瘤无进展生存时间及并发症发生率。结果所有患者均成功接受TACE联合RFA治疗,无严重治疗相关不良事件发生。两组术后并发症发生率无统计学差异(P=0.819),术后特殊部位治疗组短期肝功能轻度损害,1个月内恢复至正常范围。平均随访时间16个月,术后1个月特殊部位治疗组肿瘤完全坏死27例(93%),常规部位治疗组60例(87%)。术后1年,特殊部位治疗组及常规部位治疗组肿瘤无进展生存率(PFS)分别为72.9%及76%,两组患者肿瘤无进展生存时间无显著差异(P=0.832)。特殊部位治疗组及常规部位治疗组中位生存时间均为25个月,两组患者总生存时间无显著差异(P=0.896)。结论 TACE联合多影像引导技术精准RFA特殊部位肝细胞肝癌,可行、安全、有效。Objective To investigate the feasibility, effectiveness and safety of transcatheter arterial chemoembolization(TACE) combined with precision radiofrequency ablation(RFA) by using multiple imaging guidance technology for the treatment of HCC located at exceptional sites. Methods The clinical data of a total of 98 HCC patients, who received TACE combined with RFA at authors’ hospital during the period from April 2013 to May 2017, were retrospectively analyzed. Of the 98 patients, HCC located at common sites was seen in 69(common group), and HCC located at exceptional sites was found in 29(exceptional group). Both preoperative and postoperative enhanced CT or MRI, and laboratory examinations were performed in all patients. The patients were followed up. Complete necrosis rate of tumor, survival rate, survival time,progression-free survival(PFS) and incidence of complications were recorded, and the results were compared between the two groups. Results Successful TACE and RFA was accomplished in all patients, no procedurerelated complications occurred. No statistically significant difference in the incidence of postoperative complications existed between the two groups(P =0.819). In the exceptional group, mild short-term liver function damage was observed, which returned to normal within one month. The patients were followed up for a mean time of 16 months. One month after the treatment, complete necrosis of tumor was obtained in 27 patients(93%) of the exceptional group and in 60 patients(87%) of the common group. One year after the treatment, the PFS rates in the exceptional group and the common group were 72.9% and 76% respectively,the difference between the two groups was not statistically significant(P=0.832). The median survival time was25 months in both groups, and no statistically significant difference in the overall survival time existed between the two groups(P=0.896). Conclusion For the treatment of HCC located at exceptional sites, TACE combined with precision RFA by using multiple imaging guidance tech

关 键 词：肝细胞肝癌 特殊部位 肝动脉化疗栓塞术 射频消融术 

分 类 号：R735.7[医药卫生—肿瘤]