多次肝动脉化疗栓塞术联合射频消融在肝癌治疗中的临床应用

Clinical application on liver cancer received radiofrequency ablation after multiple hepatic transcatheter arterial chemoembolization

目的评价多次肝动脉化疗栓塞（TACE）联合射频消融（RFA）治疗肝癌的临床疗效。方法对经多次TACE治疗后仍有肿瘤残余的10例肝癌患者分别行B超引导下射频消融治疗,术后随访监测甲胎蛋白（AFP）的动态变化及肝脏CT表现来评价疗效。结果 RFA治疗后3~6个月,生存率为100%,其中9例患者AFP〈400 ng/mL,CT检查无肿瘤复发征象者8例,有肿瘤复发征象者2例。9~12个月复查,8例患者AFP〈400 ng/mL,CT增强扫描未发现肿瘤复发征象;有肿瘤复发征象的患者2例,再次行射频消融治疗。8例患者随访时间达到24个月,其中6例患者AFP〈400 ng/mL,CT增强扫描未发现肿瘤复发者7例;1例患者死亡。结论多次TACE联合射频消融为中晚期肝癌治疗提供了新的治疗思路与途径。

Objective To evaluate the clinical efficacy among liver cancer patients who received radiofrequency ablation （RFA） after multiple hepatic transcatheter arterial chemoembolization （TACE）. Methods Ten cases of liver cancer patients after multiple TACE who had residual tumor were treated by ultrasound-guided RFA. Monitoring AFP level and liver CT imaging were performed to evaluate efficacy. Results After RFA 3-6 months, survival, rate is 100% ,and 9 of 10 AFP are normal. Eight cases of CT examination are found no tumor recurrence. Two cases with tumor recurrence are received the 2nd RFA. After 9-12 months, 8 cases are AFP 〈 400 ng/mL and no tumor recurrence who examined by CT. Two cases with tumor recurrence are received the RFA. 8 cases are followed up 24 months. Six cases are AFP 〈 400 ng/mL. Seven cases are found no tumor recurrence. 1 case death. Conclusion Repeated TACE combined with RFA in advanced liver cancer treatment offers a new treatment idea. It can significantly improve the survival rate and prolong survival.