肝动脉化疗栓塞联合射频消融治疗大肝癌的疗效评价

Transcatheter arterial chemoembolization combined with radiofrequency ablation in treatment of large hepatocellular carcinoma

目的探讨经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合射频消融(radiofrequency ablation,RFA)治疗大肝癌的临床应用价值。方法回顾性分析我院2006年4月至2008年7月收治的66例肝细胞癌患者的治疗结果,根据治疗方法分为TACE+RFA组、TACE组及RFA组,其中19例行RFA联合TACE治疗(TACE+RFA组),24例单纯TACE治疗(TACE组),23例单纯RFA治疗(RFA组)。结果 TACE+RFA组的肿瘤坏死率达73.68%,明显高于单纯TACE组及单纯RFA组(分别为50.00%,52.17%,P<0.01,P<0.05)。局部复发率分别为26.32%、37.50%和30.43%,三组间无显著统计学差异(P>0.05)。TACE+RFA组的平均生存期为28.3个月,显著高于TACE组的13.6个月(P<0.01)和单纯RFA组的21.7个月(P<0.05)。结论 TACE联合RFA治疗大肝癌与单纯TACE和单纯RFA治疗效果相比,可提高肿瘤坏死率,延长患者生存期。

Objective To evaluate the efficacy of tanscatheter arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA） in treatment of large hepatocellular carcinoma. Methods A retrospective analysis was performed of 66 patients with hepatocellular carcinoma who received different treatments during April 2006-July 2008. The patients were divided into 3 groups： 19 patients in TACE ＋ RFA group, 24 patients in TACE group, and 23 patients in RFA group. Results The complete necrosis rate of tumor accounted for 73.68% in TACE ＋ RFA group which was significantly higher than that of TACE group and RFA group （50.00%, and 52.17%, respectively, P 〈 0.01, P 〈 0.05）. The local recurrence rates of tumor in TACE ＋ RFA group, TACE group, and RFA group were 26.32%, 37.5% and 30.43%（P 〉 0.05）. Mean survival time of patients in TACE ＋ RFA group was 28.3 months, which was higher than that of TACE group and RFA group （13.6 months, 21.7 months, P 〈 0.01, P 〈 0.05）. Conclusion Percutaneous transcatheter arterial chemoembolization（TACE） combined with radiofrequency ablation（RFA） in primary large hepatocellular carcinoma could improve tumor complete necrosis rate and extend the patient＇s survival time.