经导管肾动脉化疗栓塞联合射频消融术治疗肾癌的疗效分析

Transcatheter arterial chemoembolization combined with radiofrequency ablation in treatment of renal cell carcinoma

目的评价TACE联合射频消融术(RFA)治疗肾癌的疗效。方法回顾性分析我中心收治的23例肾癌患者资料。全部患者均首先行肾TACE治疗,并在3~4周后在超声及CT的联合引导下行RFA术。评价患者术前术后的卡氏功能状态评分(KPS评分)及肾功能变化情况,同时在随访期内定期对患者行腹部超声、CT/MR增强扫描评价其疗效。结果至随访终止,全部23例患者中生存21例(21/23,91.30%),死亡2例(2/23,8.70%)。全部患者在术前和随访期结束时的KPS评分及血肌酐水平差异无统计学意义(P均>0.05)。至随访结束,23例患者肾内病灶的治疗效果为完全缓解16例、部分缓解5例、进展2例。结论 TACE联合RFA治疗肾癌创伤小、疗效确切、围术期并发症少,是一种较为安全有效的方法。

Objective To evaluate the safety and effectiveness of TACE with radiofrequency ablation （RFA） in treatment of renal cell carcinoma. Methods Data of 23 cases of renal cell carcinoma were retrospectively analyzed. Firstly all patients were treated with renal TACE, and then RFA under the guidance of ultrasound and CT was performed 3 to 4 weeks later. The therapeutic effects were evaluated by enhanced CT or MR scans during the follow-up period. Meanwhile, the changes of Karnofsky Performance Status （KPS） scores and renal functions between preoperative and postoperative periods were al- so evaluated. Results To the end of the follow-up, in all 23 patients 21 cases （21/23, 91.30%） survived and 2 cases died （2/23, 8.70%）. KPS scores and serum creatinine levels were observed in all 23 patients at the initial stage and the end of the follow-up period, there were no significant differences （all P〈0.05）. At the end of follow-up, 16 cases were complete remission, 5 were partial remission and 2 were progressive disease. Conclusion TACE combined with RFA is a safe and effective method in treatment of renal cell carcinoma with less trauma, less complication and more effective.