射频消融治疗超过米兰标准肝细胞肝癌的长期疗效研究  

Radiofrequency Ablation for Hepatocellular Carcinoma Exceeding Traditional Milan Criteria: Long-term Results

作　　者：沈强[1] 许赟[1] 王能[1] 盛月红[1] 钱国军[1] 

机构地区：[1]第二军医大学东方肝胆外科医院微创一科,上海200438

出　　处：《中国微创外科杂志》2016年第9期774-776,794,共4页Chinese Journal of Minimally Invasive Surgery

基　　金："十二五"国家重大专项(项目编号:2012ZX10002016)

摘　　要：目的探讨射频消融治疗超过米兰标准,在新米兰标准下肝细胞肝癌的临床疗效。方法 2007年1月~2009年12月90例符合新米兰标准的肝细胞肝癌接受B超引导下射频（美国Radio-Therapeutics公司RF1500X射频消融仪）消融治疗,消融采用功率模式,输出功率调至200 W,采用多点位分层消融,至超声下肿瘤完全被强回声覆盖。结果 90例218个肿瘤首次完全消融209个,首次完全消融率95.9%（209/218）。严重并发症2例（2.2%）,肝脓肿1例,胆汁瘤1例,经抗感染及引流后均好转,无治疗相关死亡发生。1、3、5年总体生存率分别为92.2%、67.8%、43.9%,1、3、5年无瘤生存率分别为83.3%、48.9%、31.9%。结论射频消融是治疗新米兰标准肝细胞肝癌安全有效的方式。Objective To evaluate the clinical efficacy of radiofrequency ablation for hepatocellular carcinoma exceeding traditional Milan criteria but matching new- Milan criteria. Methods From January 2007 to December 2009, a total of 90 patients with hepatocellular carcinoma matching new- Milan criteria treated with radiofrequency ablation （RF1500X, Radio-Therapeutics） were enrolled in this retrospectively analysis. In ablation procedure, power mode was used and the output power was modulated to 200W. Multi-site and multi-layer puncture were applied until the tumor was covered with strong echo. Results Two hundred and nine lesions were ablated completely in a total of 218 lesions in the 90 patients after first treatment. The initial complete ablation rate was 95.9% （209/218）. Major complications occurred in 2 patients （2.2%） , including 1 case of liver abscess and 1 case of biloma, all of which were cured alter antibiotic treatment and drainage. No surgically related death happened. The overall survival rates at 1 , 3, and 5 years were 92.2% , 67.8% , and 43.9% , respectively. The corresponding tumor-free survival rates were 83.3% , 48.9% , and 31.9% , respectively. Conclusion Radiofrequency is a safe and effective modality for hepatocellular carcinoma exceeding traditional Milan criteria but matching new Milan criteria.

关 键 词：射频消融 肝细胞肝癌 米兰标准 

分 类 号：R735.7[医药卫生—肿瘤]