TACE联合体外高频热疗和经皮微波消融治疗大肝癌的临床疗效观察

Combination of TACE,extracorporeal high frequency hyperthermia,and percutaneous microwave ablation for large hepatocellular carcinoma

目的探讨肝动脉化疗灌注栓塞术(TACE)+体外高频热疗+经皮微波消融三种方法联合治疗大肝癌的安全性和有效性。方法回顾性分析2015年1月至2017年1月在本院肿瘤综合治疗中心住院经病理确诊为大肝癌的患者,其中将单纯行TACE治疗的患者20例列为A组、行TACE+体外高频热疗22例列为B组,2017年2月至2018年12月实施TACE+体外高频热疗+经皮微波消融23例患者列为C组;比较三组患者治疗并发症及不良反应、临床疗效、1年生存期。结果治疗前,三组患者AFP含量组间比较,差异无统计学意义(P>0.05);治疗后,三组患者AFP分别为(170.6±26.9)μg/L、(165.3±28.3)μg/L、(169.7±29.2)μg/L,均低于治疗前(536.4±50.6)μg/L、(532.3±51.1)μg/L、(537.6±50.5)μg/L,差异均有统计学意义(均P<0.05);三组患者呕吐、发热、疼痛等不良反应发生率比较,差异均无统计学意义(均P>0.05);C组治疗总有效率为73.9%,高于A组、B组25.0%、40.9%,差异有统计学意义(P<0.05);C组患者1年生存期为87.0%,高于A组、B组60.0%、72.7%,差异有统计学意义(P<0.05)。结论采用TACE+体外高频热疗+经皮微波消融三种方法联合治疗大肝癌,疗效好,安全性高。

Objective To explore the safety and efficacy of the combination of transhepatic artery chemoembolization(TACE),extracorporeal high frequency hyperthermia,and percutaneous microwave ablation for large hepatocellular carcinoma.Methods 42 patients with large hepatocellular carcinoma treated at our hospital from January,2015 to January,2017 were retrospectively analyzed;among the 42 patients,20 were treated with TACE and were set as group A,and the remaining 22 were treated with TACE and extracorporeal high frequency hyperthermia and were set as group B.From February,2017 to December,2018,23 patients were treated with TACE,extracorporeal high-frequency hyperthermia,and percutaneous microwave ablation,and were set as group C.The treatment complications,adverse reactions,clinical efficacies and 1-year survival rates were compared between the three groups.Results There was no statistical difference in AFP between these 3 groups before the treatment(P>0.05).The AFP levels of group A,B,and C were(170.6±26.9)μg/L,(165.3±28.3)μg/L,and(169.7±29.2)μg/L after the treatment,and were(536.4±50.6)μg/L,(532.3±51.1)μg/L,and(537.6±50.5)μg/L before the treatment,with statistical differences(all P<0.05).There were no statisitcal differences between the three groups in the incidences of vomiting,fever,and pain(all P>0.05).The total effective rate was 73.9%in group C,which was higher than those in group A(25.0%)and group B(40.9%),with statistical differences(P<0.05).The 1-year survival rate was 87.0%in group C,which was higher than those in group A(60.0%)and group B(72.7%),with a statistical differences(P<0.05).Conclusion The combination of TACE,extracorporeal high frequency hyperthermia,and percutaneous microwave ablation for large hepatocellular carcinoma has good effect and high safety.