经皮射频联合瘤内无水酒精注射治疗肝癌

Combining with Radiofrequency Ablation and Ethanol Injection for Treatment of Patients with Liver Cancer

目的：总结经皮肝穿射频毁损联合瘤内无水酒精注射术治疗肝癌的效果和经验。方法：经皮射频毁损与瘤内无水酒精注射术交替治疗不宜手术切除的肝癌68例。结果：随访5～15个月，经皮射频毁损与瘤内无水酒精注射术联合治疗的31例原发性单个小肝癌（≤5 cm），甲胎蛋白阳性14例，术后降至正常11例，影像学疑复发2例；9例转移性肝癌（≤5 cm）仅作单纯的经皮射频治疗，治疗后1例复发；28例大肝癌（>5 cm）病人全部首先行经皮肝动脉栓塞化疗，然后再作经皮肝穿射频毁损与瘤内无水酒精注射联合治疗，其中甲胎蛋白阳性15例，术后降至正常7例，下降但未降至正常5例，无下降或上升3例；影像学随访显示病灶好转或稳定21例，病情进展7例。联合治疗副作用不大，未见严重并发症。结论：经皮射频联合瘤内无水酒精注射适合对小肝癌的治疗或经皮肝动脉栓塞化疗后大肝癌的补充治疗，两者联合治疗可望提高肝癌局部治疗的效果。

Objectives：The aim of this study was to sum up the result and experience to combine radiofrequency ablation and ethanol injection for the treament of the patients with liver cancer. Methods：Percutaneous radiofrequency ablation and ethanol injection were used alternately to treat 68 liver cancer patients. Results：During the period of 5－15 months following-up，thirty-one patients with single small liver cancer （≤5 cm）were treated by this combining therapy. All of them survived and 2 was diagnosed as recurrence by medical imaging. Alpha-fetoprotein(AFP) decreased to normal in 11 of 14 AFP positive patients. Nine small metastatic liver cancer(≤5 cm) received single treatment of radiofrequency and one occurred recurrence. Twenty-eight patients with large liver cancer(>5 cm) received the combining therapy after one month of transcatheter arterial embolization. AFP decreased to normal in 7 of 15 AFP positive patients. Medical imaging showed the tumors shrinking or no change in 14 patients. The side effects of the combining therapy were slight and no severe adverse effect was seen. Conclusion：The therapy of combining radiofrequency ablation and ethanol injection is an eligible method for the treatment of the patients with small liver cancer or the large one after transcatheter arterial embolization, and can improve the results of local ablation therapy.