射频消融联合肝动脉化疗栓塞治疗原发性肝癌的临床探讨

Radiofrequency Ablation and Transcatheter Arterial Chemoembolization in Primary Hepatic Carcinoma

目的探讨射频消融(RFA)联合肝动脉介入栓塞化疗(TACE)治疗原发性肝癌的临床价值。方法 106例原发性肝癌患者,32例行RFA联合TACE治疗(联合组),与38例单纯TACE治疗及36例单行RFA治疗进行对照研究分析。3组病例的平均年龄、病灶大小以及肝功能分级差异无显著性意义。结果综合组的肿瘤坏死率达93.7%,明显高于单纯TACE组及单纯RFA组(分别为60.0%、43.8%,P<0.05)。三组局部复发率分别为25.0%、31.5%和30.5.0%,差异无显著性意义(P>0.05)。联合组的平均生存期为30月,高于TACE组(26.8月)与单纯RFA组(17.6月),但差异无显著性意义(P>0.05)。结论利用射频消融联合肝动脉化疗栓赛,可大大提高肿瘤组织坏死率,延长生存期。

Objective To investigate the clinical effect of a combination therapy ofpercutaneous radiofrequency ablation（RFA）and transcatheter arterial chemoembolization（TACE） in primary hepatic carcinoma. Methods Among 106 patients with hepatic carcinoma, 32 patients received a combination therapy of TACE and RFA（combination group）, 38 patients TACE alone, and the rest 36 patients RFA alone. Moreover, there was no significant difference in mean age, tumor size and liver function grade among the three groups. Results The complete necrosis rate of tumor accounted for 93.7% in combination group, which was significantly higher than that of TACE group and RFA group （50.0% and 44.4%, respectively, P〈0.05）. The local recurrence rate of tumor in the combmation group, TACE group and RFA group was 25.0%, 31.5%, and 30.5%, respectively, there was no significant difference among the three groups（P〉0.05）. Mean survival duration of combination group was 30.0 months, which was higher than that of TACE group（26.8 months）, and？ that of RFA group（17.6 months）, but there was no significant difference among the three groups（all P〉0.05）. Conclusion percutaneous radiofrequency ablation（RFA）and transcatheter arterial chemoembolization（TACE） in primary hepatic carcinoma could improve tumor complete necrosis rate and extend the patients＇ survival duration.