两种射频消融模式联合治疗肝脏恶性肿瘤的疗效分析

Efficacy of combining temperature-and power-controlled radiofrequency ablation for malignant liver tumors

背景与目的:单一射频消融模式普遍存在消融范围不够的缺点。本研究通过联合温度与功率控制模式治疗肝脏恶性肿瘤,探讨其疗效及优点。方法:2008年4月至2008年8月,58例肝脏恶性肿瘤患者在中山大学肿瘤防治中心接受了射频消融治疗。所有患者按随机数字表法分为两组:温度控制模式联合功率控制模式组(联合组)与单纯功率控制模式组(对照组)。结果:58例接受射频消融的病例中,3例失随访,有效病例55例,其中25例患者(29个肿瘤)接受了联合模式射频消融,治疗后有效率(完全缓解+部分缓解)为93.1%(27/29);30例患者(32个肿瘤)接受了单纯功率模式射频消融,治疗后有效率为90.6%(29/32)。联合组1例患者术中出现心率下降,对照组未见严重并发症。联合组的消融时间与单纯组相近[(13.3±1.3)minvs.(10.2±2.3)min,P=0.459],进针次数略少于对照组(1.3次vs.2.4次,P=0.579),但差异无统计学意义。结论:联合温度与功率控制模式治疗肝脏恶性肿瘤是安全、有效的,与单纯功率控制模式相比联合模式所需进针次数略少。

Background and Objective：Single mode of radiofrequency ablation （RFA） often leads to limited ablation in the zone of necrosis. This study clarifies the efficacy of combining temperature-and power-controlled RFA for malignant liver tumors. Methods：Between April 2008 and August 2008,58 patients with malignant liver tumors received RFA at Sun Yat-sen University Cancer Center. The patients were divided into 2 groups using a random number table：one group received combined temperature-and power-controlled RFA （the combination group）,and the other group received power-controlled RFA alone （the control group）. Results：Three patients were lost to follow-up and 55 patients were included for evaluation. Twenty-five patients with 29 tumors were treated by the combination RFA,and 27 tumors （93.1%） achieved either complete response （CR） or partial response （PR）. One patient had a seriously decreased heart rate. In the control group,30 patients with 32 tumors received power-controlled RFA,and 29 tumors （90.6%） achieved CR or PR. There were no serious complications. There was no difference between the combination and control groups in treatment time [（13.3± 1.3） min vs. （10.2± 2.3） min,P=0.459]. The number of sessions of RFA for the combination group was less than that of the control group （1.3 sessions vs.2.4 sessions）,but the difference was not significant （ P=0.579）. Conclusion：RFA controlling both temperature and power is effective and safe for patients with malignant liver tumors,and the number of sessions of RFA for the combination group was less than that of the control group.