高频热消融联合TACE治疗中晚期原发性肝癌的疗效观察

Research of high frequency induced thermotherapy efficiency for treatment of hepatocellular carcinoma

目的探讨高频热消融（HiTT）联合肝动脉化疗栓塞术（TACE）对中晚期原发性肝癌的治疗效果。方法将经病理、影像学诊断及AFP值证实的原发性肝癌符合入选条件的患者共65例，按住院号数的单、双数随机分成两组：对照组（TACE＋无水酒精消融PEI组）：32例，男26例、女6例，年龄18～78（平均52岁）；治疗组（TACE＋HiTT组）33例，男25例、女8例，年21～79岁（平均51岁）。对照组患者行TACE后2～3周给予影像导向下PEI治疗；治疗组TACE后2—3周给予影像导向下HiTT消融治疗。结果对照组治疗32例患者，1、2．3年生存率分别为73％、56％和23％，中位生存期1．876年；治疗组33例患者1、2、3年生存率分别为87％、76％和51％，中位生存期2．134年。治疗组的生存率及生存期均显著高于对照组（P〈0．05）。治疗组的介入治疗效果与死亡风险率呈显著的负相关（P〈0．05）。结论高频热消融联合TACE对中晚期原发性肝癌的治疗效果明显高于无水酒精消融（PEI）与TACE联合，可提高原发性肝癌的生存率，延长生存期。

Objective To investigate the effectiveness of high frequency induced thermotherapy in the treatment of hepatocellular carcinoma. Methods We included a 65 proven cases of hepatocellular carcinoma in which the diagnosis was confirmed by pathology, radio-imaging and AFP value. The patients were randomly divided into 2 groupsby odd or even hospitalization number. A total of 32 patients were enrolled in the TACE ＋ PEI only group and 33 patients were enrolled in the TACE ＋ HITT therapy group. Results For the 32 patients in TACE ＋ PEI only therapy group, the 1, 2, and 3 year of survival rates were 73%, 56%, and 23%, respectively, with a median survival of 1. 876 years. For patients in the therapy group, the 1, 2, and 3 year survival rates were 87%, 76%, and 51%, respectively, with a median survival of 2. 134 years. Survival rate and duration in the therapy group was significantly greater in the combination therapy group compared to the control group （P 〈 0. 05 ）. There was a negative correlation between the effectiveness of combination therapy and the mortality risk （P 〈 0. 05）. Conclusion HiTT ＋ TACE can significantly increase survival rate and extend length of survival in patients with hepatocelluar carcinoma.