经皮射频联合局部注射消融治疗肝癌疗效观察

Percutaneous radiofrequency ablation plus ethanol and cisplatin injection therapy in the management of hepatic malignancies

目的:评价经皮射频消融(PRFA)联合无水酒精及热顺铂局部注射消融治疗肝癌的疗效及安全性。方法:2001年2月至2004年9月采用B超引导下PRFA联合无水酒精及热顺铂局部注射治疗肝癌76例109个病灶,原发性肝癌40例,转移性肝癌36例。肿瘤直径1.5～15.0cm,应用RF-2000和10电极LeVeen射频针。对1～2cm的小肿瘤选择Chiba针进行局部注射消融,而对>3cm者应用Quadra-Fuse多位穿刺注射针。结果:PRFA及局部注射消融治疗经过均顺利,并发症4例(5.3%),无相关死亡。随访率96.1%,随访期12～43个月,缓解率(CR+PR)为94.7%。患者1、2、3年生存率分别为96.1%、75.4%和42.9%。结论:PRFA联合局部注射消融是原发性及转移性肝癌的有效微创疗法。

Objective To assess the local treatment efficacy and safety of percutaneous radiofrequency ablation （PRFA） in combination with percutaneous ethanol injection （PEI） and cisplatin injection ablation therapy for hepatic malignancies. Methods From February 2001 to September 2004, a total of 109 hepatic malignant lesions （φ1.5 - 15.0 cm） in 76 patients were ablated by B-ultrasound guided PRFA plus ethanol and cisplatin injection ablation therapy. PRFA was completed by using RF-2000 generator and 10-needle LeVeen electrode. The Chiba needle and Quadra-Fuse multi-pronged needle were used in injection ablation therapy for tumors ranged 1 - 2 cm and for those larger than 3 cm respectively. Results The procedures were performed successfully in all patients. The post-treatment complication rate was 5.3%. The follow-up rate was 96. 1% with a period of 12 -43 months. The effective rate （CR ＋ PR） was 94. 7%. The patients survival rates were 96. 1% at 1 year, 75.4% at 2 years, and 42.9% at 3 years, respectively. Conclusion The restdts of this study suggest that the treatment protocol of PRFA plus ethanol and cisplatin injection was an effectively combined mini-invasivly local ablation therapy for the primary and metastatic hepatic malignancies.