肝动脉化疗栓塞联合CT引导下射频消融术治疗肝癌的疗效分析

Therapeutic combination of hepatic arterial chemoembolization with CT-guided radiofrequency ablation for hepatocellular carcinoma:an analysis of curative effect

目的评价肝动脉化疗栓塞(TACE)联合CT引导下射频消融术(RFA)治疗肝癌的疗效。方法HCC患者200例先行TACE术,然后在CT引导下行RFA术。200例患者共行TACE术495例次。肿瘤病灶共计378个,直径为0.5～16 cm,共行RFA术362人次,663个位点。结果术前、术后12个月AFP分别为(2 156.79±574.61)ng/ml、(269.53±146.65)ng/ml,两者差异有统计学意义(t=16.11,P<0.01)。术前、术后3、6和12个月的肿瘤体积分别是(72.64±24.74)cm3、(46.78±18.95)cm3、(28.27±11.70)cm3和(10.82±8.31)cm3,差异有统计学意义(F=10.77,P<0.01)。肿瘤完全坏死率为87.8%。结论肝TACE联合CT引导下RFA治疗肝癌是一种有效的微创治疗方法。

Objective To evaluate the combination therapy of CT-guided radiofrequency ablation （RFA） and transcatheter arterial chemoembolization （TACE） in treating hepatocellular carcinoma （HCC）.Methods TACE followed by CT-guided RFA treatment was performed in 200 patients with HCC, including 164 males and 36 females （aged 19 - 81 years）. TACE procedures totaled 495 times. The lesions amounted to 378, with the diameter of （0.5 - 16） cm. Three hundred and sixty-two RFA procedures were performed for the ablation at 633 targeted points. Results AFP level before and 12 months after the procedure was （2 156.79 ± 574.61） ng/ml and （269.53 ± 146.65） ng/ml respectively, with a significant difference between the two （t = 16.11, P 〈 0.01）. The tumor volume before and 3, 6, 12 months after the treatment was （72.64 ± 24.74）cm^3, （46.78 ± 18.95）cm^3, （28.27 ± 11.70）cm^3 and （10.82 ± 8.31）cm^3 respectively, the difference between them was of statistically significance （F = 10.77, P 〈 0.01 ）. The complete necrosis rate of the tumor was 87.8%. Conclusion The treatment of TACE with successive CT-guided RFA is an effective and minimally-invasive therapy for HCC.