CT引导下射频消融术在肝脏恶性肿瘤患者治疗中的应用

Application of CT-guided radiofrequency ablation in the treatment of liver cancer

目的探讨CT引导下射频消融术(RFA)在肝脏恶性肿瘤治疗中的临床应用。方法选取2011年3月到2016年3月间江苏省泰州市第二人民医院收治的80例肝脏恶性肿瘤患者,采用随机数表法分为试验组和对照组,每组40例。给予试验组患者CT引导下的射频消融治疗,给予对照组患者常规肝动脉灌注化疗栓塞术(TACE)治疗。观察两组患者治疗后6个月、1年和2年内的存活率,比较不同时间点两组患者的肿瘤体积,检测治疗前和治疗后3个月两组患者血清肿瘤标志物(甲胎蛋白和癌胚抗原)的水平。结果治疗后6个月两组患者的存活率比较,差异无统计学意义(P>0.05),治疗1年和2年后试验组的存活率明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的肿瘤体积都缩小,且与治疗前比较差异有统计学意义(P<0.05),但是治疗6个月和治疗12个月以后,试验组患者的肿瘤体积较对照组患者更小,差异有统计学意义(P<0.05);治疗后两组患者甲胎蛋白和癌胚抗原水平均显著降低,差异有统计学意义(P<0.05),且试验组患者均显著低于对照组患者,差异有统计学意义(P<0.05)。结论 CT引导下的RFA治疗肝脏恶性肿瘤,可以有效提高治疗的远期疗效,值得临床推广。

Objective To investigate the clinical application of CT-guided radiofrequency ablation in the treatment of liver cancer. Methods A total of 80 patients with liver cancer who admitted to our hospital from March 2011 to March 2016 were selected and were randomly divided into an experimental group and a control group. Each group had 40 patients. CT-guided radiofrequency ablation was applied to experimental group. Conventional transcatheter arterial chemoembolization（ TACE） was applied to the control group. The survival rates were observed in the two groups at 6 months,1 year and 2 years after the treatment. Tumor volume was compared between the two groups. Levels of serum tumor markers（ α-fetoprotein and carcino-embryonic antigen） were detected at three months after the treatment. Results There was no significant difference in survival rate between the two groups（ P〈0. 05） at 6 months after the treatment.The 1-year and 2-year survival rate was significantly higher in the experimental group than in the control group（ P〈0. 05）. After the treatment,the tumor volume reduced in both groups（ P〈0. 05） but after 6months and 12 months of treatment,the tumor volume was smaller in the experimental group than in the control group（ P〈0. 05）. Tumor markers significantly decreased in the two groups after the treatment（ P〈0. 05）. The levels of tumor markers were significantly lower in the experimental group than in the control group（ P〈0. 05）. Conclusion CT guided radiofrequency ablation can effectively improve the long-term efficacy in the treatment of liver cancer,which is worthy of clinical promotion.