射频消融与姑息手术治疗胰头癌的临床对比分析

The contrasting analysis between radiofrequency ablation and palliative surgery in pancreatic head cancer

目的评估术中冷循环射频消融治疗不能切除的胰头癌的有效性和安全性。方法回顾性分析比较15例使用冷循环射频消融+姑息手术与13例单用姑息手术治疗不能切除的胰头癌患者的术后并发症和生存率。结果所有患者均获得随访,围手术期死亡率为0。使用冷循环射频消融+姑息手术治疗的患者存活12个月以上10例,最长者已达42个月,中位生存期24.6个月。单用姑息手术治疗的患者中位生存期10.2个月。冷循环射频消融治疗患者术后腰背部疼痛减轻明显。但术后胰瘘、消化道出血等并发症的发生率增加。结论术中冷循环射频消融治疗不能切除的胰头癌是安全有效的。

Objective To evaluate the efficacy and the safety of radiofrequency ablation （RFA） in the treatment of unresectable pancreatic head cancer. Methods A retrospective study was adopted to analyze comparatively the clinical data which included pain, complication and the survival rate of 28 patients of unresectable pancreatic head cancer treated with different ways. Fifteen patients were treated with radiofrequency ablation and palliative surgery, and 13 patients were treated with palliative surgery. Results All the patients were followed up. Overall median survival rate in patients receiving palliative therapy alone was 10.2 months. When radiofrequency ablation was applied, median survival was estimated at 24.6 months and the maximum survival reached 42 months. Patients with back pain got pain relief postoperatively when radiofrequency ablation was applied, but the incidence of the postoperative complication of that pancreatic fistulas and gastrointestinal hemorrhage was higher than that with palliative surgery. Conclusion Radiofrequency ablation is an effective and safe for the treatment of unresectable pancreatic head cancer.