CT引导射频消融治疗结直肠癌肝转移的应用价值

Application value of CT-guided radiofreguency ablation on metastatic liver carciaoma caused by colorectal cfmcer

目的探讨CT引导下射频消融（RFA）治疗结直肠癌肝转移的适应证、治疗方案及疗效。方法选择56例（124个病灶）经临床及病理确诊为结直肠癌肝转移并拟行RFA者纳入本研究。肿瘤平均直径为（3．5±1．4）cm，直径≥4cm肿瘤占32．3％（40／124病灶），单发肿瘤占32．1％（18例）。所有患者均行增强CT检查，根据病灶数目、大小、形态、浸润范围、位置、与周围结构关系等确定RFA适应证。本研究56例均给予常规CT引导下经皮射频消融治疗，经1～4个月增强CT检查随访评价疗效。结果56例124个病灶根据增强CT检查结果制定方案，行RFA分期治疗及扩大消融治疗。肿瘤灭活率为93．5％（116／124病灶），局部复发率为8．0％（10／124病灶），新生转移率为39．3％（20／56例）。结论CT引导下射频消融是治疗结直肠癌肝转移的重要辅助方法，增强CT为肝转移癌适应证选择和治疗方案制定提供参考依据。

Objective To investigate the indications, therapeutic regimen and effects of CT- guided radio frequency ablation （RFA） in the treatment of metastatic liver carciaoma caused by coloreetal cancer. Methods Fifty-six patients（ 124 lesions）clinically and pathologically diagnosed with metastatic liver carcinoma caused by colorectal cancer scheduled for RFA were included into this study. The average diameter of the tumors was （3.5± 1.4） cm, tumors with diameter 〉14 cm accounting for 32.3 % （40/124 leisions） , single tumor accounting for 32. 1% （ 18 leisions）. All patients were examined by contrasted enhanced CT examination, the indications of RFA were made according to leision numbers, size, shape, infiltration range, location and relations with the surrounding structures. All the 56 patients were treated by conventional CT-guided pereutanous RFA. The effects were evaluated by contrasted enhanced CT ex- amination during the 1 to 4 months follow-up. Results According to the results of contrasted enhanced CT examination, 56 patients （124 lesions） were given RFA staging treatment and expanding ablation treatment. Tumor deactivation rate was 93.5% （ 116/124 lesions） , local recurrence rate was 8.0% （ 10/ 124 lesions） ,and new metastasis rate was 39.3% （20/56 cases）. Conclusions CT-guided radio fre- quency ablation is an important supplementary method for the treatment of metastatic liver carcinoma caused by colorectal cancer, enhanced CT examination can provide reference for indications selection and treatment scheme made of metastatic liver carciaoma.