| CT导向下射频消融联合TACE治疗原发性肝癌 |
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| 引用本文： | 李征然,康庄,钱结胜,朱康顺,姜在波,黄明声,关守海,单鸿.CT导向下射频消融联合TACE治疗原发性肝癌[J].南方医科大学学报,2007,27(11):1749-1751,1755. |
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| 作者姓名： | 李征然 康庄 钱结胜 朱康顺 姜在波 黄明声 关守海 单鸿 |
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| 作者单位： | 中山大学附属第三医院介入治疗专科,广东,广州,510630 |
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| 摘 要： | 目的 回顾性评价CT导向下射频消融(RFA)联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床疗效及并发症情况.方法 原发性肝癌患者46例,单个肿瘤直径≤5 cm,总数不超过3个,其中19例患者直接行CT导向下经皮经肝穿刺肝内瘤灶射频消融(RFA组),27例在RFA治疗前1～3周先行肝动脉化疗栓塞术(TACE RFA组).结果 TACE RFA组的肿瘤完全毁损率21/27例(77.8%)明显高于单纯RFA组11/19例(57.9%)(P＜0.01).TACE RFA组局部复发率为22.2%(6/27),明显低于RFA组的42.1%(8/19)(P＜0.01).TACE RFA组和RFA组血清AFP转阴率分别为73.9%和43.8%(P＜0.01).术后常见并发症包括发热、疼痛和不同程度肝功能损害,经护肝和对症治疗后多可缓解和恢复.3例患者术后出现肝包膜下出血,经卧床和止血治疗后停止.结论 RFA术前联合TACE治疗可明显提高肿瘤的完全坏死率,获得更为确切的临床疗效,减少术后肿瘤的复发;CT导向下经皮穿刺射频消融治疗原发性肝癌是一种安全有效的治疗手段.
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| 关 键 词： | 肝肿瘤 射频消融 肝动脉化疗栓塞术 |
| 文章编号： | 1673-4254（2007）11-1749-03 |
| 修稿时间： | 2007-07-16 |
Radiofrequency ablation with or without transcather arterial chemoembolization for management of hepatocellular carcinoma |
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| LI Zheng-ran,KANG Zhuang,QIAN Jie-sheng,ZHU Kang-shun,JIANG Zai-bo,HUANG Ming-sheng,GUAN Shou-hai,SHAN Hong.Radiofrequency ablation with or without transcather arterial chemoembolization for management of hepatocellular carcinoma[J].Journal of Southern Medical University,2007,27(11):1749-1751,1755. |
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| Authors: | LI Zheng-ran KANG Zhuang QIAN Jie-sheng ZHU Kang-shun JIANG Zai-bo HUANG Ming-sheng GUAN Shou-hai SHAN Hong |
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| Affiliation: | Department of Interventional Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China |
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| Abstract: | Objective To evaluate the efficacy and complications of radiofrequency ablation(RFA) with or without transcatheter arterial chemoembolization(TACE) for management of hepatocellular carcinoma(HCC).Methods A retrospective analysis was conducted for 62 small HCC cases undergoing RFA with or without TACE,and in each case,the tumors were not more than 3 with a diameter below 5 cm.Nineteen cases were managed with RFA alone(RFA group) while the other 27 underwent RFA combined with TACE(TACE RFA group).Percutaneous RFA(RITA 1500) procedure was performed under CT guidance 1-3 weeks after TACE in TACE RFA group.Results The complete tumor necrosis rate was 77.8%(21/27) in TACE RFA group,significantly higher than that in RFA group 57.9%(11/19),P<0.01],and the former group had a significantly lower local recurrence rate than the latter 22.2%(6/27) vs 42.1%(8/19),P<0.01].Postoperative fever,local pain and temporary hepatic function abnormality were the common complications that were relieved after proper interventions,and mortality did not occur in these cases.Conclusion The combination of TACE and RFA significantly increases the complete tumor necrosis rate and decreases the recurrence rate of small HCC.CT-guided percutaneous RFA can be a safe and effective therapy for small HCC. |
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| Keywords: | liver neoplasms radiofrequency ablation transcatheter arterial chemoembolization |
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