TACE联合RFA治疗BCLC中晚期肝癌患者预后的影响因素分析  

Prognostic factors of primary liver cancer patients in BCLC intermediate and advanced stage after TACE combined with RFA

作　　者：李一帆 顾俊鹏[1] 纪卫政[1] 张海潇[1] 朱帝文[1] 任伟新[1] Li Yifan;Gu Junpeng;Ji Weizheng;Zhang Haixiao;Zhu Diwen;Ren Weixin(Department of Interventional Radiology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院介入放射科,乌鲁木齐830054

出　　处：《中华肝脏外科手术学电子杂志》2020年第6期557-561,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：新疆医科大学临床医学高峰学科校内配套经费资助项目(33-0104006020801)。

摘　　要：目的探讨TACE联合射频消融(RFA)治疗BCLC中晚期原发性肝癌(肝癌)患者预后的影响因素。方法回顾性分析2011年1月至2016年7月新疆医科大学第一附属医院接受TACE联合RFA治疗的66例肝癌患者临床资料。患者签署知情同意书,符合医学伦理学规定。其中男52例,女14例;年龄41~79岁,中位年龄59岁。肝功能Child-Pugh分级A级49例,B级17例。BCLC分期B期27例,C期39例。生存预后因素分析采用Kaplan-Meier法单因素分析和Cox多因素回归分析。结果本组患者中位总体生存期(OS)为26(9~65)个月,中位无疾病进展生存期(PFS)为15(3~58)个月。Cox多因素回归分析显示,门静脉癌栓为OS和PFS的独立危险因素(HR=6.147,6.421;P<0.05)。多次RFA治疗和口服替吉奥治疗为PFS的独立保护因素(HR=0.199,0.259;P<0.05)。结论适当增加RFA治疗次数和辅助替吉奥治疗对控制TACE联合RFA治疗的BCLC中晚期肝癌患者肿瘤进展有益。门静脉癌栓是患者预后的独立危险因素,应积极预防。Objective To explore the prognostic factors of primary liver cancer(PLC)patients in Barcelona Clinic Liver Cancer(BCLC)intermediate and advanced stage treated with TACE and radiofrequency ablation(RFA).Methods Clinical data of 66 patients with PLC who received TACE combined with RFA in the First Affiliated Hospital of Xinjiang Medical University from January 2011 to July 2016 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,52 patients were male and 14 female,aged 41-79 years,with a median age of 59 years.49 patients were assessed with Child-Pugh grade A liver function and 17 cases grade B.27 cases were classified as BCLC stage B and 39 cases stage C.The prognostic factors were analyzed by univariate Kaplan-Meier survival curve and multivariate Cox's regression analysis.Results The median overall survival(OS)and median progression-free survival(PFS)of patients were 26(9-65)months and 15(3-58)months,respectively.Multivariate Cox's regression analysis showed that portal vein tumor thrombus was an independent risk factor for OS and PFS(HR=6.147,6.421;P<0.05).Multiple RFA and tegafur treatment were the independent protective factors for PFS(HR=0.199,0.259;P<0.05).Conclusions Proper increase RFA and tegafur treatment are beneficial to control the tumor progression of PLC patients in BCLC intermediate and advanced stage after TACE combined with RFA.Portal vein tumor thrombus is an independent risk factor for clinical prognosis of patients,which should be prevented with active interventions.

关 键 词：肝肿瘤 化学栓塞 治疗性 射频消融 预后 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]