超声引导下经皮消融治疗复发性肝母细胞瘤的初步研究  

Ultrasound-guided percutaneous ablation treatment for current hepatoblastoma： initial single-center experience

作　　者：李鹏亮[1] 罗佳[1] 张晓儿 刘保娴 周路遥[1] 黄光亮[1] 陕泉源 谢晓燕[1] Li Pengliang Luo Jia Zhang Xiaoer Liu Baoxian Zhou Luyao Huang Cuangliang Shan Quanyuan Xie Xiaoyan(Department of Medical Ultrasonics, Institute of Diagnostic and lnterventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China)

机构地区：[1]中山大学附属第一医院超声医学科,中山大学超声诊断与介入超声研究所,广州510080

出　　处：《中国医师杂志》2017年第6期813-816,共4页Journal of Chinese Physician

摘　　要：目的回顾性总结应用超声引导下经皮消融技术治疗复发性肝母细胞瘤的初步经验。方法2013年8月至2015年4月于中山大学附属第一医院行超声引导下经皮消融治疗复发性肝母细胞瘤患儿6例（男4例，女2例，年龄1岁11个月至11岁）。经过肝切除手术后的2～73个月发现肝母细胞瘤复发，5例位于肝内，I例位于左肺边缘。6例患儿共9个复发灶行超声引导下经皮消融治疗，病灶直径0．7～3．9（1．5±0．8）em。结果4例患儿的6个病灶行射频消融治疗，2例患儿的4个病灶行酒精消融治疗。6例患儿的消融成功率为100％（6／6），病灶第一次消融的完全消融率为88．9％（8／9）。消融后无严重并发症，仅1例患儿消融后出现发热（〉39℃），对症治疗后缓解。随访5～30个月，3例患者因肿瘤进展去世。消融后1年和2年累积生存率分别为83．3％和41．7％。结论超声引导下经皮消融治疗复发性肝母细胞瘤是一种可供选择的安全的治疗方式，其疗效期待大样本多中心的进一步研究。Objective To summarize the first experience with ultrasound-guided percutaneous ablation treatment （PAT） for recurrent hepatoblastoma （HB） after liver resection in children. Methods From August 2013 to April 2015, PAT was used to treat 6 children with a total of 9 recurrent HB, including 5 patients with 8 tumors in the liver and 1 patient with 1 tumor in the lung. The mean size of ablated tumors was （ 1.5±0. 8） cm, and the tumor size range was 0.7 cm to 3.1 cm. Results Four patients were per-formed percutaneous radiofrequency ablation （RFA） for recurrent HB; and 2 patients were performed per-cutaneous ethanol injection （PEI）. Ablation success was achieved in all patients （6/6, 100% ）. The complete ablation rate after the first ablation session was 88.9% （8/9） on a tumor-by-tumor basis. Only 1 pa-tient developed a fever with temperature 〉 39%; it was resolved by conservative therapy. During the fol- low-up period of 5 -30 months, 3 patients died to tumor progression. The 1- and 2-year overall survival rates after ablation were 83.3% and 41.7%, respectively. Conclusions PAT is a safe and promising therapy for children with recurrent HB after liver resection, and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.

关 键 词：超声检查 导管消融术 肝肿瘤/治疗 复发 

分 类 号：R735.7[医药卫生—肿瘤]