肝转移癌射频消融疗效及与化疗关系探讨:附134例分析

Efficacy of radiofrequency ablation combined with chemotherapy: results in 134 cases of liver metastases

目的评价经皮射频消融(RFA)结合化疗对肝脏转移性肿瘤(MLC)的疗效。方法134例336个MLC经皮射频消融治疗,根据接受化疗情况分为:RFA组40例,RFA前化疗组52例,RFA后化疗组8例,RFA前后全化疗组34例。结果灭活率为95.8%,11.6%病灶局部复发增大;前化疗组复发病灶率(6.3%)与后化疗组(23.5%)及全化疗组(19.1%)有显著差异(P<0.01)。本组病例中位生存时间为(21.0±2.2)个月。结论RFA微创治疗MLC局部灭活率高,并可对再发或复发病例反复多次治疗而有效延长患者生存期,并具有并发症少、患者生存质量高的优势;本组病例显示RFA治疗MLC有良好的应用前景。

Objective To investigate the efficacy of radiofrequency ablation （RFA） and chemotherapy in metastatic liver carcinomas （MLC）. Methods The treatment results of 134 patients with 336 MLCs by ultrasound-guided RFA were retrospectively analyzed. The 134 patients were divided into 4 groups according to chemotherapy condition： 40 patients underwent RFA treatment alone （group I ）; 52 patients received RFA and systematic chemotherapy before RFA （group Ⅱ ）; 8 patients received RFA and systematic chemotherapy after RFA （group Ⅲ） ; the rest 34 patients had RFA and chemotherapy before and after RFA （group Ⅳ）. Results In the 134 patients, the tumor necrosis rate was 95.8^ and local recurrence was found in 39 tumors （11.6 % ） 2--19 months after RFA treatment. There was significant difference in local recurrence rate between group Ⅱ and group Ⅳ. The medial overall survival was （21.0±2. 2） months. Conclusion RFA could effectively ablate MLC and could be safely repeated for recurrences or new tumors; therefore benefit the patient＇s survival. It will play increasing important role in treating MLC.