肝动脉化疗栓塞联合射频消融术治疗大肝癌的疗效及生存分析  

Transcatheter hepatic arterial chemoembolization combined with radiofrequency ablation for large hepatocellular carcinomas: clinical analysis of therapeutic efficacy and survival rate

作　　者：高飞[1] 庞志刚[1] 韩斌[1] 陈文超[1] 黄高峰[1] 

机构地区：[1]郑州大学第二附属医院普外科,450014

出　　处：《介入放射学杂志》2016年第4期316-319,共4页Journal of Interventional Radiology

摘　　要：目的研究肝动脉化疗栓塞(TACE)联合射频消融术(RFA)对比单一TACE治疗大肝癌患者的临床疗效及生存分析。方法回顾性分析2011年7月—2014年7月接受治疗的原发性大肝癌患者67例,按治疗方式的不同分为对照组(仅行TACE治疗)32例和研究组(TACE联合RFA治疗)35例,采用修订的实体瘤治疗疗效评价标准(m RECIST标准)判定治疗后的近期疗效,并对所有患者随访。结果术后1个月对患者治疗的近期疗效进行评估,研究组CR为68.5%(24/35),PR为22.8%(8/35),SD为8.6%(3/35),对比对照组CR为40.6%(13/32),PR为46.8%(15/32),SD为6.3%(2/32),PD为6.3%(2/32),两组患者CR及PR间差异有统计学意义(P=0.022,P=0.039),但两组的客观有效率(ORR)以及疾病控制率(DCR)差异无统计学意义(P>0.05);研究组1、2、3年生存率分别为74.3%、44.1%、20.5%,中位生存时间为22个月,对照组术后生存率分别为52.8%、23.1%、7.9%,中位生存时间为13个月。两组对比分析生存率差异有统计学意义(P=0.035)。结论应用TACE联合RFA治疗大肝癌患者具有良好的近期疗效,但与单一TACE相比差异无统计学意义,远期疗效方面能有效延长患者的生存时间,两种治疗方法优势互补,对于大肝癌患者的远期预后水平具有重要的临床意义。Objective To investigate the therapeutic efficacy of transcatheter arterial chemoembolization（TACE） combined with radiofrequency ablation（RFA） for large hepatocellular carcinomas, to analyze the survival rate of patients, and to compare it with simple TACE therapy. Methods The clinical data of 67 patients with large hepatocellular carcinoma, who were admitted to the Second Affiliated Hospital of Zhengzhou University to receive treatment during the period from July 2011 to July 2014, were retrospectively analyzed. According to the treatment plan, the patients were divided into the control group（receiving only TACE, n=32） and the study group（receiving TACE together with RFA, n=35）. The short-term therapeutic effect was evaluated with modified response evaluation criteria in solid tumors（m RECIST）. All patients were followed up after treatment. Results One month after the treatment, in the study group CR, PR and SD were obtained in 68.5%（24/35）, 22.8%（8/35） and 8.6%（3/35） of patients respectively, while in the control group CR, PR, SD and PD were obtained in 40.6%（13/32）, 46.8%（15/32）, 6.3%（2/32） and 6.3%（2/32） of patients respectively. Statistically significant differences in CR and PR existed between the two groups（P=0.022 and P =0.039 respectively）, although the differences in objective effective rate（ORR） and disease control rate（DCR） between the two groups were not significant（P〉0.05）. The one-year, 2-year and 3-year survival rates in the study group were 74.3%, 44.1% and 20.5% respectively with a median survival time of22 months, while in the control group those were 52.8%, 23.1%, and 7.9% respectively with a median survival time of 13 months; the differences between the two groups were statistically significant（P =0.035）.Conclusion For the treatment of large hepatocellular carcinomas, combination use of TACE and RFA carries excellent short-term effect, although its effect is not significantly different with the effect of simple TACE treatme

关 键 词：大肝癌 肝动脉化疗栓塞 射频消融术 

分 类 号：R735.7[医药卫生—肿瘤]