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作 者:沈立杰[1] 严鹏[1] 张娟娜[1] 张会爽[1] 徐坤鹏[1]
机构地区:[1]邢台医学高等专科学校第二附属医院肿瘤治疗中心,河北邢台054000
出 处:《医学影像学杂志》2015年第10期1836-1839,共4页Journal of Medical Imaging
摘 要:目的 比较CT引导下氩氦刀冷冻治疗(AHC)、射频消融治疗(RF)和微波消融(MWA)治疗肝癌的消融效果及远期疗效。方法 2009年1月~2012年1月收治的肝癌患者164例,其中52例(84个结节)采用氩氦刀冷冻消融技术,56例(100个结节)采用RF消融技术,56例(114个结节)采用MWA消融技术,观察三组患者治疗后肿瘤消融率、复发率、1~2年生存率及并发症发生情况。结果AHC、RF组和MWA组的肝癌完全消融率分别为97.6%(82/84)、90.0%(90/100)和89.5%(102/114),差异无统计学意义(P=0.28)。局部复发率分别为11.5%(6/52)、14.3%(5/56)和17.8%(10/56),差异无统计学意义(P=0.83)。AHC组无并发症发生(0/52),RF组和MWA组并发症发生率为7.1%(4/56)和10.7%(6/56),差异无统计学意义(P=0.25)。三组手术治疗患者随访1年无瘤生存率分别为92.3%、88.1%和82.5%;随访2年的无瘤生存率为75.0%、65.2%、68.1%,Log-rank检验显示三组肝癌患者生存期之间的差异无统计学意义(2=0.07,P=0.97)。结论 氩氦刀冷冻消融、射频消融和微波消融治疗肝癌的完全消融率、并发症和远期生存率无显著差别,在临床治疗中,要根据患者的具体情况,合理选择治疗方式,取长补短,以便达到满意的治疗效果。Objective To explore and compare the treatment effect of liver cancer by applying Ar-He Cryablation (AHC), Radiofrequency Radiation (RF) and microwave ablation (MWA), and to provide basis for clinical premium treatment technology selection. Methods 164 liver cancer cases were selected during 2009 and 2012 in accordance with the preset selection criteria and then distributed into AHC group (52 cases, 84 tumors), RF group (56 cases, 100 tumors) and MWA group (56 cases, 114 tumors), 2 year follow up were implemented after the treatment, and the tumor ablation rate, reoccurrence rate, and complications were observed and calculated. Results Tumor complete ablation rate in AHC was 97.6%, and 90.0% in RF group and 89.5% in MWA group, but the differences between three groups were not statisti cally significant. The tumor reoccurrence rate was relatively lower in AHC group (11.5%) than in RF group (14. 3%) and MWA (17.8%) during the 2 years of follow up, but the differences were not statistically significant ( P =0.83). Post-treatment complication incidence was 0% in AHC group, while 7.1% in RF group and 10.7% in MWA group, but the differences were neither statistically significant ( P =0.25). The first year survival rate after treatment was 92.3% in AHC group, 88.1% in RF group and 82. 5% in MWA group, and the second year survival rate was 75. 0% in AHC group, 65.2 % in RF group and 68.1 % in MWA group, Log-rank test indicated that the survival period between AHC and RF and MWA was not statistically significant (X2 =0.07, P =0.97). Conclusion AHC and RF and MWA are 3 treat ments that have their respective advantage, which achieved ideal therapeutic effect. There are no differences in the aspect of tumor ablation rate, reoccurrence rate, and complications, so select preferable clinical treatment method according to patients' real condition is crucial to achieve ideal effect.
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