肝动脉灌注化疗栓塞术联合射频消融术治疗肝癌的疗效与安全性分析

The Efficacy and Safety of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation for Hepatocellular Carcinoma

目的探讨肝动脉灌注化疗栓塞术(TACE)联合射频消融术(RFA)治疗肝癌(HCC)的疗效与安全性。方法按照随机分组的方法将114例HCC患者分为观察组和对照组,各57例。对照组接受TACE治疗,观察组于TACE治疗后2~3周后在DSA引导下行RFA治疗。比较2组治疗前及治疗后12个月的AFP值及肿瘤体积,比较2组治疗后肿瘤完全坏死率及治疗总有效率,随访1年、2年及3年生存率并统计分析不良反应发生情况。结果 2组患者均能耐受治疗,治疗后AFP值及肿瘤体积变化与治疗前比较均有改善(P<0.05)。观察组治疗后12个月AFP值及肿瘤体积变化均优于对照组,2组比较差异有统计学意义(P<0.05);观察组肿瘤完全坏死率及治疗总有效率均优于对照组,2组比较差异有统计学意义(P<0.05);观察组1年、2年及3年随访生存率均高于对照组,2组比较差异均有统计学意义(P<0.05)。结论 TACE联合RFA术治疗HCC可提高患者的治疗有效率、肿瘤完全坏死率,控制肿瘤病灶,延长患者的生存期,具有较高的临床应用价值。

Objective To study the efficacy and safety of transcatheter arterial chemoembolization( TACE) combined with radiofrequency ablation( RFA) for hepatocellular carcinoma( HCC). Methods 114 HCC patients were randomly divided into the observation group and the control group. The control group received TACE and the observation group received RFA combined with TACE through digital subtraction angiography. The alpha fetoprotein( AFP),tumor volume,rate of complete necrosis of tumor and total effective rate of the 2 groups were compared. The survival rate and complications were observed. Results All the patients were well tolerated. The AFP and tumor volume of the observation group at 12 months after the treatment were better than those of the control group( P < 0. 05). The rate of complete necrosis of tumor and total effective rate of the observation group were higher than those of the control group( P < 0. 05). The survival rate at 1 year,2 year and 3 year follow-up of the observation group were higher than those of the control group( P < 0. 05). Conclusion TACE combined with RFA can improve the rate of complete necrosis of tumor and total efficiency,control the tumor lesions and prolong the survival time of HCC patients,which has highly clinical application value.