表柔比星化疗栓塞联合射频消融治疗BCLC0/A期原发性肝癌的疗效和安全性

Efficacy and Safety of Epirubicin Chemoembolization Combined with Radiofrequency Ablation in the Treatment of BCLC0/A Primary Liver Cancer

探讨表柔比星化疗栓塞联合射频消融(RFA)治疗巴塞罗那分期(BCLC)0/A期原发性肝癌(PLC)的疗效和安全性。选择2010年1月至2014年1月在该院就诊的PLC患者作为研究对象,共纳入患者86例,采用随机数字表法将患者分为常规组和联合组各43例。常规组给予常规化疗栓塞联合RFA治疗,联合组则采用常规化疗+表柔比星栓塞联合RFA治疗。观察2组患者临床疗效、局部肿瘤进展(LTP)、进展时间(TTP)、总生存期(OS)、肝功能检查和并发症。常规组和联合组临床治疗完全缓解率分别为90.70%和100%,联合组3年、5年LTP率低于常规组,常规组患者中位TTP为18个月,联合组为24个月,差异有统计学意义(P<0.05)。常规组患者中位OS为69个月,联合组中位OS为74个月,且2组患者术前、术后1月AST、ALT、TB组内、组间比较差异均无统计学意义(P>0.05);2组患者发热、腹痛荨麻疹发生率比较差异无统计学意义(P>0.05)。BCLC 0/A期PLC患者联合表柔比星化疗栓塞并在早期行CT引导RFA治疗可减少局部肿瘤进展,延长进展时间,更有利于患者预后,值得进一步研究探讨。

To explore the efficacy and safety of epirubicin chemoembolization combined with radiofrequency ablation(RFA)in the treatment of Barcelona stage(BCLC)stage 0/A primary liver cancer(PLC).A total of 86 patients were selected as PLC patients from January 2010 to January 2014 in our hospital.The random number table method was used to divide the patients into the conventional group and the combined group.The conventional group was given conventional chemoembolization combined with RFA treatment,and the combined group was given conventional chemotherapy+epirubicin embolization combined with RFA treatment.The clinical efficacy,local tumor progression(LTP),time to progression(TTP),overall survival(OS),liver function tests and complications of the 2 groups were observed.The complete remission rates of clinical treatment in the conventional group and the combined group were 90.70%and 100%,respectively.The 3-year and 5-year LTP rates of the combined group were lower than the conventional group.The median TTP of patients in the conventional group was 18 months and the combined group was 24 months,the difference was statistically significant(P<0.05).The median OS of patients in the routine group was 69 months,and the median OS in the combined group was 74 months.There was no statistically significant difference in AST,ALT,and TB between the two groups before and after the operation(P>0.05);There was no significant difference in the incidence of fever and abdominal pain urticaria between the two groups(P>0.05).BCLC stage 0/A PLC patients combined with epirubicin chemoembolization and early CTguided RFA treatment can reduce local tumor progression,prolong the progression time,and be more conducive to patient prognosis.It is worthy of further study and discussion.