肝动脉栓塞联合经皮射频消融术治疗原发性大肝癌50例疗效分析

Effect of TACE combined with RFA for the treatment of massive primary hepatocellular carcinomas: an analysis of 50 cases

目的 ：探讨肝动脉化疗栓塞（TACE）联合经皮射频消融术（RFA）治疗原发性大肝癌的治疗效果。方法：回顾分析2007年6月—2015年6月50例大肝癌患者,行PACE联合RFA治疗,分析其术后临床症状、甲胎蛋白（AFP）、肝功能等指标,随访4-60个月,随访终点为患者死亡或随访期结束（2015年6月）,采用Kaplan-Meier进行生存分析。结果：经TACE联合RFA治疗后,患者AFP明显下降,肿瘤组织直径减小,至随访结束,随访4-60个月,平均（42.22±16.77）月,完全缓解10例（20%）,部分缓解2例（4%）,疾病进展4例（8%）,死亡34例（68%）。全组病例中位生存期45个月,1、3、5年生存率分别为92.0%、62.0%、32.0%。结论：TACE联合RFA治疗直径〉5 cm的原发性肝癌安全有效,可以延长生存时间,改善患者生存质量。

Objective： To investigate the efficacy and safety of Transarterial Chemoembolization（TACE）combined with Radiofrequencyablation（RFA）to treat Hepatocellular Carcinoma（HCC）.Methods： 50 HCC patients with the treatment of TACE and RFA during June 2007 to June 2015 were enrolled in this study. The clinical symptom, serum AFP and hepatic function were assessed.All the patients were followed up for 4- 60 month; the estimated overall survival and median for survival time were analyzed statistically. Results： After the treatment the clinical symptoms were relieved in all patients and serum AFP levels in all patients were decreased obviously, and the volume of the tumor was reduced. To the end of the follow up period, complete remission was obtained in10 cases, partial remission 2 cases, progression of disease 4 cases and death 34 cases. The estimated median survival time was 45 months. The 1-, 3-, 5- year survival rates were 92.0%, 62.0%and 32.0%, respectively. Conclusion： TACE＋RFA was an effectively treatment for patients with HCC bigger than 5cm. The estimated overall survival is excellent.