序贯性肝动脉化疗栓塞联合射频消融治疗大肝癌的临床研究

Observation of the results in the treatment of Sequential hepatic arteria chemoembolization,percuta-neous radiofrequency ablation for hepatocellular carcinoma

目的：探讨经肝动脉栓塞化疗（TACE）联合射频消融（RFA）治疗大肝癌的可行性及临床疗效。方法将70例肝癌患者随机分为联合组（TACE ＋RFA）37例，对照组（单纯 TACE）33例，两组疗法均可重复操作，直至 CT 显示肿瘤消融完全。随访1～2年，评价疗效。结果联合组肿瘤完全坏死和 AFP 水平下降＞50％的患者均高于对照组，差异有统计学意义（P ＜0．05）；联合组的1年、2年生存率均比对照组高，差异有统计学意义（P ＜0．05）。结论 TACE ＋RFA 治疗直径5～9cm 的肝癌疗效确切，安全可行，可以成为治疗大肝癌的有效方法。

Objective To investigate the efficacy and safety of combination of transcatheter arterial chemoembolization (TACE)and percutaneous radiofrequency ablation (RFA)in treatment of hepatocellular carcinoma (PHC).Methods 70 cases of PHC were divided into combined group (TACE +RFA,n =37) and control group (only TACE,n =33).Patients were followed up for1 to 2 years,and the therapeutic effects and side effects were compared between the two groups.Results The patients with tumor completely necrosis and AFP level lower than >50% in combined group were significantly more than those in control group (P <0.05);the half of year,one year and two years survival rate in combined group were greatly higher than those of control group;no severe side effect was observed in two groups.Conclusions TACE+RFA is effective and safe in treatment of PHC of more than 5 cm in diameter.