肝动脉栓塞化疗联合射频消融与联合微波消融治疗原发性肝癌的疗效和安全性比较  

The curative effect and safety in treating primary hepatocellular carcinoma:comparison between TACE plus radiofrequency ablation and TACE plus microwave ablation

作　　者：王晓维[1] 付守忠[1] 戴锋[1] 王斌[1] 丁苇[1] 沈建东[1] 殷梦杰 

机构地区：[1]江苏省南通市第三人民医院介入科,226300

出　　处：《介入放射学杂志》2016年第8期673-676,共4页Journal of Interventional Radiology

摘　　要：目的对比肝动脉栓塞化疗(TACE)联合射频消融(RFA)或联合微波消融(MWA)的近期局部疗效、安全性及生存率。方法回顾性分析采用TACE联合RFA治疗或联合MWA治疗的原发性肝癌患者,比较两组术后AFP、肝功能、不良反应、并发症、术后3个月的影像学表现以及1年生存率情况。结果射频联合组术后3个月边缘复发率9.8%,微波联合组23.7%,差异无统计学意义(P>0.05);射频联合组术后AFP平均下降为(412.47±373.81)ng/ml,微波联合组平均下降为(278.72±269.20)ng/ml,差异无统计学意义(P>0.05);术后射频联合组ALT平均升高至(81.22±49.50)U/L、AST平均升高至(93.71±50.94)U/L,微波联合组ALT平均升高至(139.53±97.77)U/L,AST平均升高至(181.43±140.16)U/L;两组ALT及AST对比有统计学意义(P<0.001);两组术后不良反应无明显差异,射频联合组并发症1例,微波联合组并发症2例,差异无统计学意义(P>0.05),两组术后均未出现与治疗相关的死亡病例,1年生存率无差异(P>0.05)。结论 TACE联合RFA或联合MWA的近期局部疗效、并发症及1年生存率无显著差异,但射频联合组术后比微波联合组术后肝功能损伤轻微。Objective To compare the short-term local efficacy, safety and survival rate between transeatheter hepatic arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA） and TACE combined with microwave ablation （MWA） in treating primary hepatocellular carcinoma （PHC）. Methods A total of 68 patients with PHC were included in this study. TACE plus RFA was performed in 37 patients （RFA group）, and TACE plus MWA was adopted in 31 patients （MWA group）. The postoperative AFP level, hepatic function, adverse reaction and complication were recorded, the imaging findings at three months after treatment and one-year survival rate were analyzed. Results Three months after the treatment, the recurrence rates at lesion＇s edge in RFA group and MWA group were 9.7% and 23.7% respectively, the difference was not statistically significant （P〉O.05） ; the average reductions in postoperative AFP levels in RFA group and MWA group were （412.47±373.81） ng/ml and （278.72±269.20） ng/ml respectively, the difference was not statistically significant （P〉0.05） ; the mean increase values in postoperative ALT and AST levels in RFA group were （81.22±49.50） U/L and （93.71±50.94） U/L respectively, which were （139.53± 97.77） U/L and （181.43±140.16） U/L respectively in MWA group, the differences between the two groups were statistically significant （P〈0.001）. No statistically significant difference in the incidence of postoperative adverse reaction existed between the two groups. Complication occurred in one patient of RFA group and two patients of MWA group, the difference was not statistically significant （P〉0.05）. No treatment-related death occurred in both groups. No statistically significant difference in one-year survival rate existed between the two groups （P〉0.05）. Conclusion For the treatment of PHC, the short-term local efficacy, complication and one-year survival rate of TACE plus RFA are not significantly different from those of TACE plu

关 键 词：肝细胞癌 肝动脉栓塞化疗 射频消融 微波消融 疗效评价 

分 类 号：R735.7[医药卫生—肿瘤]