经导管动脉化疗栓塞联合射频消融治疗原发性肝癌临床观察

Clinical Observation of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation in Treatment of Primary Hepatic Cancer

目的探讨经导管动脉化疗栓塞(TACE)联合射频消融(RFA)治疗原发性肝癌的效果。方法实验对象来自2009年2月—2011年2月河北大学附属医院收治的、经临床检查确诊为原发性肝癌患者96例。其中单纯行TACE治疗者32例(单纯TACE治疗组),单纯行RFA治疗者32例(单纯RFA治疗组),行TACE联合RFA治疗者32例(TACE联合RFA治疗组)。比较3组治疗前及治疗后3周血肝功能及AFP,治疗后3个月肿瘤影像学成像变化,治疗后6个月疗效,1、2、3年生存率,并发症发生情况。结果 13组治疗后3周较治疗前ALB和ALT均无显著变化(P>0.05);AFP仅TACE联合RFA治疗组显著降低(P<0.05)。23组治疗后3个月较治疗前癌灶直径显著减小、癌灶个数显著减少(P<0.05),TACE联合RFA治疗组较另两组癌灶直径减小、癌灶个数减少更为明显(P<0.05)。3TACE联合RFA治疗组治疗后6个月有效率显著高于另两组(P<0.05)。4TACE联合RFA治疗组1、2、3年生存率显著高于另两组(P<0.05),单纯RFA治疗组3年生存率显著高于单纯TACE治疗组(P<0.05)。53组相同并发症发生率比较,差异无统计学意义(P>0.05)。结论 TACE联合RFA治疗原发性肝癌较单独应用TACE或RFA更为安全有效。

Objective To explore the effect of transcatheter arterial chemoembolization （ TACE） combined with radiofrequency ablation （ RFA） in treatment of primary liver cancer. Methods A total of 96 patients with primary liver cancer confirmed by clinical examination during February 2009 and February 2011 were recruited in this study including 32 patients with conventional TACE treatment （group A）, 32 patients with RFA treatment （group B） and 32 patients with TACE combined with RFA treatment （ group C） . In the three groups, levels of liver function and blood alpha-feto-protein （ AFP） before and three weeks after treatment, imaging changes of tumor imaging 3 months after treatment, the curative effects 6 months after treatment, survival rates of 1st, 2nd and 3rd year and incidence rates of complications were compared. Results The differences in levels of albumin （ ALB） and alanine transarninase （ ALT） before and 3 weeks after treatment in the three groups were not statistically significant （P〉0. 05）;the AFP level in group C after treatment was significantly reduced （P〈0. 05）. The cancer diameters and counts of the three groups 3 months after treatment were significantly decreased compared with those before treatment （P〈0. 05）, and the difference in group C was more signifi-cant compared with those in group A and B （P〈0. 05）. The effective rate in group C was significantly higher 6 months after treatment than those in group A and B （P〈0. 05）. The survival rates of 1st, 2ndand 3rd year in group C were signifi-cantly higher than those in group A and B （ P〈0. 05 ）; while the survival rate of 3 rd year in group B was significantly higher than that in group A （P〈0. 05）. The differences in incidence rates of same complications in the three groups was not statistically significant （P〉0. 05）. Conclusion TACE combined with RFA in treatment of primary liver cancer is safer and more effective compared with conventional TACE or RFA therapy.