CT引导下经皮冷热交替复合式冷冻消融治疗肝脏恶性肿瘤近期效果及其安全性  

Short-term efficacy and safety of CT-guided percutaneous compound cryoablation for liver malignancies

作　　者：关海涛[1] 李甜甜 范则杨 王健[1] 邹英华[1] GUAN Haitao;LI Tiantian;FAN Zeyang;WANG Jian;ZOU Yinghua(Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China;Department of Gastroenterology,Feicheng People's Hospital,Taian 271600,China)

机构地区：[1]北京大学第一医院介入血管外科,北京100034 [2]肥城市人民医院消化内科,山东泰安271600

出　　处：《中国介入影像与治疗学》2023年第4期198-201,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察CT引导下复合式冷冻消融治疗肝脏恶性肿瘤的近期效果及其安全性。方法回顾性分析45例接受CT引导下经皮冷热交替复合式冷冻消融(康博刀)治疗的肝脏恶性肿瘤患者,包括原发性肝细胞癌(HCC)20例、肝转移癌25例;共治疗50个病灶,对18例20个(16例1个病灶、2例2个)病灶行根治性消融,对27例30个(25例1个、1例2个、1例3个)病灶行姑息性消融,记录术中及术后不良反应。于术后1、3和6个月复查腹部增强CT或MR,参照改良实体瘤疗效评价标准(mRECIST)判断疗效。结果45例均顺利完成消融治疗,其中37例采用单针、8例采用双针进行消融。6例术中及术后肝周少量积血或积液,1例术中局部皮肤轻度冻伤,术后8例轻度恶心,均自行或经对症处理后恢复。20个根治性消融病灶术后1个月均达完全缓解(CR),术后3、6个月均为19个(19/20,95.00%)CR、1个(1/20,5.00)疾病进展(PD);30个姑息性消融病灶术后1个月25个(25/30,83.33%)部分缓解(PR)、5个(5/30,16.67%)疾病稳定(SD),术后3个月22个(22/30,73.33%)PR、7个(7/30,23.33%)SD、1个(1/30,3.33%)PD,术后6个月17个(17/30,56.67%)PR、7个(7/30,23.33%)SD、6个(6/30,20.00%)PD。结论CT引导下复合式冷冻消融治疗肝脏恶性肿瘤近期疗效及安全性均较好。Objective To observe the short-term efficacy and safety of CT-guided percutaneous compound cryoablation for liver malignancies.Methods Data of 45 patients with malignant liver tumor who underwent CT-guided percutaneous compound cryoablation(Combo knife)were retrospectively analyzed,including 20 cases of primary hepatocellular carcinoma(HCC)and 25 cases of liver metastases.Totally 50 liver lesions were treated,including curative ablations of 20 lesions(18 cases,16 cases with 1 and 2 cases with 2 lesions)and palliative ablations of 30 lesions(27 cases,25 cases with 1,1 case with 2 and 1 case with 3 lesions).Intraoperative and postoperative adverse reactions were recorded.Enhanced abdominal CT or MR were re-examined 1,3 and 6 months after treatments,and the therapeutic efficacies were evaluated according to the modified-response evaluation criteria in solid tumors(mRECIST).Results All 45 patients successfully completed ablation,37 underwent single needle ablation and 8 received double needle ablation.Small amount of fluid accumulation or blood around the liver were noticed in 6 cases during and after treatments,mild local skin frostbite during operation occurred in 1 case,mild nausea complained after treatment by 8 cases,all improved spontaneously or after symptomatic treatment.Among lesions after curative ablation,complete remission(CR)was found in all 20 lesions 1 month after treatment,while 19(19/20,95.00%)CR and 1(1/20,5.00%)progressive disease(PD)were observed 3 and 6 months after treatment.Among lesions after palliative ablation,partial remission(PR)was found in 25(25/30,83.33%)lesions and stable disease(SD)was detected in 5(5/30,16.67%)lesions 1 month after treatment,while 22(22/30,73.33%)of PR,7(7/30,23.33%)of SD and 1(1/30,3.33%)of PD were noticed 3 months after treatment,and 17(17/30,56.67%)of PR,7(7/30,23.33%)of SD and 6(6/30,20.00%)of PD were observed 6 months after treatment.Conclusion The short-term efficacy and safety of CT-guided percutaneous compound cryoablation for liver malignancies were both goo

关 键 词：肝肿瘤 冷冻消融 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]