肝动脉灌注化疗栓塞联合DSA引导下射频消融术治疗肝癌100例疗效评估

Hepatic arterial chemoembolization combined with DSA-guided radiofrequency ablation for the treatment of hepatocellular carcinoma:evaluation of the therapeutic effect

目的评价肝动脉灌注化疗栓塞术(TACE)联合DSA引导下射频消融术(RFA)治疗肝癌的临床疗效。方法回顾性分析100例先接受TACE治疗,然后在DSA引导下行RFA治疗的肝癌患者的临床资料,对其疗效进行分析。结果联合治疗后肿瘤的完全坏死率为85.4%。联合治疗术前、术后12个月AFP值分别为(1 956.79±514.61)ng/ml、(243.53±128.65)ng/ml,差异有统计学意义(t=14.22,P<0.01)。术前及术后3、6、12个月的肿瘤体积分别为(70.16±23.59)、(49.28±19.35)、(30.17±12.14)和(11.78±9.13)cm3,术后各期与术前比较差异均有统计学意义(F=9.98,P<0.01)。结论 TACE联合DSA引导下RFA是肝癌安全有效的微创治疗法。

Objective To evaluate the clinical effectiveness of transcatheter arterial chemoembolization （TACE） combined with DSA- guided radiofrequency ablation （RFA） in treating hepatocellular carcinoma （HCC）. Methods TACE was performed in 100 patients with HCC, which was followed by DSA-guided RFA. The clinical data were retrospectively analyzed. The clinical efficacy was evaluated. Results After the combination therapy, complete necrosis of the tumor was obtained in 87.8% of patients. AFP level decreased from preoperative （l 956.79 ± 514.61 ） ng/ml to postoperative （243.53 ± 128.65） ng/ml that was determined at 12 months after the treatment. The difference was statistically significant （t = 14.22, P 〈 0.01 ）. The tumor volumes determined before and 3, 6 and 12 months after the treatment were （70.16 ± 23.59） cm3, （49.28 _± 19.35） cm3, （30.17 ± 12.14） em3 and （11.78 ± 9.13） cm3, respectively. Significant difference existed between preoperative level and each one of postoperative levels （F：9.98, P 〈 O.01）. Conclusion For hepatocellular carcinoma, TACE together with DSA-guided RFA is a safe, effective and minimally-invasive therapy.（J Intervent Radiol, 2013, 22： 810-813）