氩氦刀冷冻消融联合肝动脉栓塞化疗术治疗中晚期肝癌的疗效分析  

Argon- helium cryoablation combined with transcatheter arterial chemoembolization for the treatment of advanced hepatocellular carcinoma: analysis of therapeutic effectiveness

作　　者：叶伟东[1,2,3] 纪建松[1,2,4] 涂建飞[1,2,4] 虞作春[1,2,3] 杨杰[1,2,3] 

机构地区：[1]浙江大学丽水医院 [2]温州医科大学附属第五医院 [3]丽水市中心医院感染科,丽水323000 [4]丽水市中心医院放射科,丽水323000

出　　处：《介入放射学杂志》2015年第5期392-395,共4页Journal of Interventional Radiology

基　　金：浙江省科技厅重大科技专项(2013C03010);浙江省卫生厅项目(2010KYB137);浙江省卫生厅项目(2010KYA192);丽水市科技局项目(2012JYZB20)

摘　　要：目的评价氩氦刀冷冻消融联合肝动脉栓塞化疗术（TACE）对中晚期原发性肝癌的疗效。方法回顾性分析66例临床或病理确诊原发性肝癌患者的临床资料,根据治疗方式分为TACE组31例,联合组（冷冻消融联合TACE）35例,随访时间5~35个月,通过评估完全缓解率、总有效率及生存时间等方面来比较2种方法的近、远期疗效。结果 2组比较,在总有效率、完全缓解率方面,联合组均优于TACE组（P〈0.05）,联合组生存期长于TACE组（P=0.038）。在0.5年、1年、2年总体生存率方面,联合组与TACE组相比,差异无统计学意义。结论对于中晚期原发性肝癌,冷冻消融联合TACE治疗能提高患者近期疗效并延长生存期,但确切效果还有待大样本、多中心随机对照研究证实。Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization （TACE） in treating advanced hepatocellular carcinoma （HCC）. Methods The clinical data of 66 patients with pathologically-proved HCC were retrospectively analyzed. Based on the therapeutic scheme the patients were divided into TACE group （n=31） and combination group （TACE＋argon-helium cryoablation, n=35）. All the patients were followed up for 5-35 months. The complete remission rate, total effective rate and survival time were evaluated. The short-term and the long-term effectiveness were compared between the two groups. Results Both the complete remission rate and total effective rate of the combination group were significantly higher than those of TACE group （P〈0.05）. The median survival time of the combination group was significantly longer than that of TACE group （P=0.038）. The half-year, one-year and 2-year overall survival rates of the combination group were higher than those of TACE group, although the differences were not statistically significant （P＆gt;0.05）. Conclusion For the treatment of advanced hepatocellular carcinoma, argon-helium cryoablation combined with TACE can improve the short-term effect and prolong the progression-free survival time, although its exact effectiveness still needs to be confirmed by large sample, multi-central and randomized controlled studies.

关 键 词：肝肿瘤 冷冻消融 TACE 疗效 

分 类 号：R735.7[医药卫生—肿瘤]