冷循环射频消融联合肝动脉栓塞化疗治疗不宜手术切除的肝癌

目的:总结冷循环射频消融术联合经导管肝动脉栓塞化疗术(transcatheter arterial chemoembolization,TACE)治疗不宜手术切除肝癌的效果和经验.方法:采用冷循环射频消融术联合TACE治疗手术不宜切除肝癌31例(共44个肿瘤结节).结果:肝功能指标中除术后ALT水平较术前明显升高(P<0.05)外,其他各项指标均无统计学差异(各P>0.05).术中、术后发生窦性心动过缓、高钾血症及急性胰腺炎各1例(3/29,10.3%),无手术死亡.术后CT检查显示:44个肿瘤结节中,37个病灶(占84.1%)为完全坏死,5个病灶(占11.4%)为不完全坏死,2个(占4.5%)病灶为部分坏死.随访3~28个月,术后1年肿瘤复发率为20.7%(6/29),1年生存率为89.7%(23/29).结论:冷循环射频消融联合TACE治疗不宜手术切除的肝癌是安全有效的.

Combination of radiofrequency ablation with cooled-tip electrodes and transcatheter arterial chemoembolization for treatment of unresectable liver cancer

Objective:To summarize the results and experience of combining radiofrequency(RF) ablation with cooled-tip electrodes and transcatheter arterial chemoembolization(TACE) for the treatment of patients with unresectable liver cancer.Methods:Thirty-one patients(totally with 44 tumors) with unresectable liver cancers underwent the treatment of combination of radiofrequency ablation with cooled-tip electrodes and TACE.Results:Among parameters of liver function,the levels of glutamic-alanine transaminase increased significantly after RF(P<0.05),and no important changes in levels of other indexes were observed(all P>0.05). There was no operation death in this study,and three minor complications occurred in three patients(3/29,10.3%) during or after operations:sinus bradycardia,hyperkalemia and acute pancreatitis. CT scan obtained after RF ablation showed that complete necrosis was achieved in 37 tumors(84.1%),nearly complete necrosis in 5 tumors(11.4%) and partial necrosis in 2 tumors(4.5%) in 44 tumors nodules. All patients were followed-up ranging from 3 months to 28 months. The tumor recurrent rate within one year was 20.7%(6/29),and 1-year survival rate was 89.7%(23/29).Conclusion:The therapy combining RF ablation with cooled-tip electrodes and TACE for patients with unresectable liver cancer is effective and safe.