肝动脉化学栓塞联合经皮射频消融序贯治疗大肝癌的临床研究

Clinical application of transcatheter arterial chemoembolization combined with percutaneous radiofrequency in the treatment of large hepatic tumors

目的:探讨肝动脉化学栓塞联合经皮射频消融序贯治疗大肝癌的临床应用价值。方法:42例原发性肝癌患者,14例行TACE联合RFA序贯治疗(联合组),与15例单纯TACE治疗及13例单纯RFA治疗组进行对照分析。比较3组的肿瘤坏死率以及平均生存期。结果:联合组的肿瘤坏死率达78.6%,明显高于单纯TACE组及单纯RFA组(分别为26.7%、46.2%,P<0.05)。局部复发率分别为21.4%、46.7%和38.5%,三者差异无显著性意义(P>0.05)。联合组的平均生存期为25.1月,高于TACE组(14.5月,P<0.05),与单纯RFA组(19.9月)差异无显著性意义(P>0.05)。结论:肝动脉化学栓塞联合经皮射频消融序贯治疗大肝癌与单纯TACE和单纯RFA组治疗结果相比,可提高肿瘤完全坏死率并延长患者生存期。

Objective： To investigate the clinical role of transcatheter arterial chemoembolization （TACE） combined with percutaneous radiofrequency ablation （RFA） in the treatment of large hepatic tumors. Methods. All of 42 patients with hepatocetlular carcinomas were divided into three groupsCombination group consisted of 14 patients ,received a combination therapy of TACE and RFA ;Fifteen patients were given the second TACE therapy only, And 13 patients with RFAtherapy were the third group. The tumor necrosis rate and mean survival duration were observed. Results： Tumor necrosis rate was 78.6% in combination group , which was significantly higher than those in TACE group and RFA group （26.7% ,46.2% ,P 〈0.05）.Tumor local recurrence was 21.4% ,46.7% and 38.5% in the combination group, TACE group and RFA group. And there was no significant difference among the three groups（P〉0.05）. Mean survival duration of combination group was 25.1 months, which was higher than that in TACE group （14.6 months）（P〈0.05）.But it was similar to RFA group （19.9months）（P〉0.05）. Conclusions： Compared with TACE or RFA therapy ,the combination therapy improved tumor necrosis rate and prolonged the patients＇ survival duration.