小肝癌射频治疗远期疗效分析  

Long-term efficacy of radiofreaquency ablation in treatment of small hepatocellular carcinoma

作　　者：张岚[1,2,3] 谢晓莺[1,2,3] 干育红[1,2,3] 任正刚[1,2,3] 葛宁灵[1,2,3] 陈漪[1,2,3] 

机构地区：[1]复旦大学附属中山医院肝癌研究所,上海200032 [2]复旦大学癌变与侵袭原理教育部重点实验室,上海200032 [3]复旦大学附属中山医院肝肿瘤内科,上海200032

出　　处：《同济大学学报（医学版）》2014年第4期85-89,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨小于3 cm的原发性肝癌射频治疗后的安全性和有效性。方法回顾性分析了复旦大学肝癌研究所2004年1月至2009年1月期间186例接受射频治疗的原发性肝癌患者的临床资料,所有患者的肿瘤直径≤3 cm,肿瘤数目≤2个。术后1个月行增强磁共振以明确射频毁损疗效,以后定期随访血生化和影像学检查。采用Kaplan-Meier模型进行生存分析。结果中位随访时间为67个月（1∽106个月）,中位生存时间为（66.00±11.84）个月。1-,3-和5-年生存率分别为96%,75%和55%,中位无瘤生存时间为（29.00±3.68）个月。完全消融毁损率为99.0%。多因素分析显示,肝功能Child-Pugh分级是影响总生存时间的唯一危险因素（P=0.03）。所有患者无严重并发症,没有手术相关死亡。结论射频消融对于小肝癌患者是一种有效且安全的治疗方法,尤其对于≤3 cm的肿瘤。伴有肝硬化的极早期原发性肝癌患者应首选射频消融治疗。Objective To evaluate the safety and efficacy of rediofrequence ablation （RFA） in treatment of small hepatocellular carcinoma （HCC）. Methods One hundred and eighty-six patients of small HCC （diameter ≤ 3 cm） undergoing RFA from January 2004 to January 2009 were reviewed retrospectively. The patients were regularly followed up with blood and radiologic tests after the RFA treatment. Clinical outcomes （survival rates, time to progression） were analyzed. And changes in liver function and tumor markers, and the complications after RFA were observed as well. Survival curve was constructed with the Kaplan-Meier method. Results During the median follow-up period of 67 months （range 1 -106 months）, the median survival time was （66.0 ± 11.8） months, and the 1 -, 3 - and 5 - year overall survival rates were 96%, 75% and 55%, respectively. The median time to tumor-free survival was 29.0± 3.68 months. Multivariate analysis showed that Child Pugh grade was the only predictive factor for overall survival （P = 0. 03 ）. No patient suffered from major complications related to RFA procedure. Conclusion RFA is an effective and safe therapeutic modality for small HCC, it can be recommended as the first choice for small HCC.

关 键 词：射频消融 原发性肝肿瘤 总生存时间 

分 类 号：R735.7[医药卫生—肿瘤]