射频消融联合肝动脉化疗栓塞治疗肝癌的应用

Clinical application of radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of liver cancer

以超声、CT等为主要引导方式的经皮射频消融(RFA)等局部热消融技术在肝癌治疗中发挥了重要的作用。然而,对血供丰富的较大肝癌疗效受限。经肝动脉化疗栓塞(TACE)可有效减少肝癌的血供,并具有创伤小,适应证广,并发症少等特点,成为肝癌患者姑息治疗及术前、术后新辅助治疗的有效手段之一。因此,富血供肝肿瘤RFA治疗前应用TACE,通过栓塞肿瘤供血动脉造成肿瘤缺血,进而减少血流带走热量,可扩大消融范围提高RFA疗效,是肝癌RFA联合治疗常用的方法。本文针对RFA联合TACE治疗肝癌的应用现状及疗效进行综述。

Percutaneous radiofrequency ablation （RFA） and other local thermal ablation techniques, which use ultrasound, CT, etc. as the main guide ways, have played an important role in the treatment of liver cancer. However, the curative effect of these techniques for hypervascular larger liver cancers is limited. Transcatheter arterial chemoembolization （TACE） can effectively reduce the blood supply of liver cancer, besides, TACE is minimally-invasive with less complication, and it carries wide indications. Therefore, TACE has become one of the effective therapeutic means and has been clinically used as the palliative therapy or as preoperative and postoperative adjunctive therapy. Through embolization of tumor-feeding arteries, preoperative TACE can cause tumor ischemia, which can reduce the quantity of heat that will be carried away by the blood flow during RFA, thus, the ablated extent can be enlarged and the clinical effect of RFA can be further improved. Combination use of TACE and RFA has been a common method for hypervaseular larger liver cancer. This paper aims to make a comprehensive review about the clinical application status and curative effect of RFA in the treatment of hepatic cancer.