Dyna计算机断层扫描在肝动脉化疗栓塞即时联合射频消融治疗孤立性大肝癌的应用价值  

The clinical efficacy of Dyna computer tomography guided radiofrequency ablation combined immediately with transarterial chemoembolization to treat large solitary hepatocellular carcinomas

作　　者：袁宏军 刘凤永[1] 李鑫[1] 管阳[1] 王茂强[1] Yuan Hongjun;Liu Fengyong;Li Xin;Guan Yang;Wang Maoqiang.(Department of Interventional Radiology, Chinese PLA General Hospital, Beifing 100853, China)

机构地区：[1]解放军总医院介入放射科,100853

出　　处：《中华肝胆外科杂志》2018年第5期294-298,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金（81671800）;北京市自然科学基金（7172204）

摘　　要：目的评价Dyna计算机断层扫描（DynaCT）技术在肝动脉化疗栓塞（TACE）后即时联合射频消融（RFA）治疗孤立性大肝癌中的技术方法和应用价值，为临床合理应用DynaCT提供依据。方法回顾性分析解放军总医院介入放射科2014年1月至2015年10月收治的23例孤立性大肝癌（肿瘤最大径≥5cm）患者资料。患者于TACE后即时联合DynaCT引导下射频消融治疗。评估联合手术成功率、操作时间、患者接受的射线剂量、并发症以及即时联合治疗的疗效。结果手术成功率为100％，手术时间为（45．3±4．8）min，射线暴露剂量为（730．5±78．8）mGy，术后并未出现严重并发症。术后1个月目标病灶完全缓解率91．3％（21／23）、部分缓解率8．7％（2／23）。随访期内死亡5例，6、12、18个月生存率分别为100％、81．5％、48．0％。结论DynaCT引导射频消融孤立性肝癌的可行性及安全性值得肯定。TACE和RFA的即时联合为孤立性大肝癌的治疗提供了新的可选策略，DynaCT具有重要的临床应用价值。Objective To study the clinical efficacy of Dyna computer tomography （Dyna CT） guided radiofrequency ablation （RFA） followed immediately by transcatheter arterial chemoembolization （TACE） in the treatment of large solitary hepatocellular carcinomas （HCC） , and to provide the basis for the rational use of Dyna CT. Methods A retrospective analysis was performed on 23 patients with a large solitary hepatocellular carcinoma （ tumor diameter 〉15 cm） who were admitted to Chinese PLA General Hospital from January 2014 to October 2015 and treated with Dyna CT guided RFA followed immediately by TACE. After treatment, the success rate of the combined technique, the treatment time, the radiation dose received by the patient, the complication and the efficacy of the combined therapy were evaluated. Results The success rate of the combined technique was 100%. The treatment time was （45.3 ±4.8） rain. The radiation exposure dose was （730.5 ±78.8） mGy. There was no serious complication after treatment. The complete remission rate of the targeted lesion was 91.3% （21/23） , the partial remission rate was 8.7% （2/23）. On follow-up, 5 patients had died. The 6, 12, 18 month survival rates were 100% , 81.5% and 48.0% , respectively. Conclusions Dyna CT guided RFA for a large solitary HCC was efficacious and safe. The im- mediate combination of TACE with RFA provided a new alternative strategy for the treatment of a large solita- ry HCC. Dyna CT has important clinical values.

关 键 词：癌 肝细胞 化学栓塞 治疗性 放射学 介入性 Dyna CT 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]