肝动脉化疗栓塞术联合射频消融术治疗不可切除肝细胞癌的疗效分析  

Therapeutic effect of TACE combined with RFA in the treatment of unresectable hepatocellular carcinoma

作　　者：黄群国[1] 刘启榆[1] 周莹[1] 何瑜[1] 张顺源[1] HUANG Qun-guo;LIU Qi-yu;ZHOU Ying(Radiology department,Mianyang Central Hospital,Mianyang Sichuan,621000,China)

机构地区：[1]四川省绵阳市中心医院放射科,四川绵阳621000

出　　处：《中西医结合肝病杂志》2020年第6期502-505,515,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨肝动脉化疗栓塞术(TACE)联合射频消融术(RFA)治疗不可切除肝细胞癌(HCC)的安全性和有效性。方法:收集2016年5月至2019年3月于我院放射科接受TACE联合RFA治疗的52例HCC患者(71个病灶)作为观察组,以同期行TACE治疗的49例HCC患者(69个病灶)为对照组。分析两组患者手术并发症、肿瘤局部控制率及中短期生存率,并对患者生存时间进行单因素分析。结果:所有患者TACE、RFA手术均顺利完成,成功率为100.0%。大多数患者手术耐受性良好,仅出现恶心、呕吐、疼痛、发热等轻微并发症,经对症处理后均得以缓解。治疗后1个月,观察组患者肿瘤局部控制率为64.8%(46/71),与对照组比较,观察组患者病灶直径<50 mm组CR率显著高于直径≥50 mm组,差异有统计学意义(P<0.05)。随访3~37个月,平均(15.1±8.0)个月,观察组患者半年、1年、2年、3年累积生存率分别为96.2%、83.6%、48.1%、32.7%,显著高于对照组(P<0.05)。单因素分析显示,两组患者不同性别、年龄、病灶数量、病灶部位、Child-Pugh分级、既往治疗史分组间生存时间差异均无统计学意义(均P>0.05)。结论:TACE联合RFA治疗不可切除HCC安全、有效,值得临床推广应用;直径较小的病灶提示联合治疗后有较好的近期疗效。Objective:To investigate the safety and efficacy of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in the treatment of unresectable hepatocellular carcinoma(HCC).Methods:A total of 52 HCC patients(71 lesions) who underwent TACE combined with RFA in the Department of Radiology,Mianyang Central Hospital from May 2016 to March 2019 were enrolled as the observation group,and 49 patients with HCC who underwent TACE treatment at the same time(69 lesions)were included in the control group.And analyzed surgical complications,local tumor control rate,and short-term survival.Patient survival time was analyzed by univariate analysis.Results:All patients with TACE and RFA were successfully completed,and the technical success rate was 100.0%.Most patients were well tolerated,with only minor complications such as nausea,vomiting,pain,and fever,which were alleviated after symptomatic treatment.One month after the treatment,the local control rate of the observation group was 64.8%(46/71).Compared with the control group,the CR rate of the lesion group <50 mm was significantly higher than that of the diameter ≥50 mm group.Statistical significance(P<0.05).The patients were followed up for 3 to 37 months,with an average of(15.1±8.0) months.The cumulative survival rates of the observation group were 96.2%,83.6%,48.1%,and 32.7%,respectively, which were significantly higher than those of the control group(P<0.05).Univariate analysis showed that there was no significant difference in survival time between different genders,ages,number of lesions,lesions,Child-Pugh classification,and previous treatment history(P>0.05).Conclusion:TACE combined with RFA is safe and effective for the treatment of unresectable HCC,and it is worthy of clinical application.Smaller lesions suggest a better short-term outcome after combined treatment.

关 键 词：肝细胞癌 肝动脉化疗栓塞术 射频消融术 

分 类 号：R735.7[医药卫生—肿瘤]