TACE联合射频消融治疗原发性肝癌疗效的影响因素分析

目的 探讨射频消融(RFA)联合TACE治疗原发性肝癌完全缓解的影响因素.方法 62例原发性肝癌患者在TACE后1个月内在静脉麻醉下行CT引导RFA治疗,在1个月后采用多期增强CT或平扫加动态增强MRI评估肿瘤是否完全消融.结果 完全消融率为79%,肿瘤残留率21%.肿瘤最大径在30 mm以下的完全消融率为100%,30 ～ 50 mm完全消融率为92.6%,50 ～ 70 mm完全消融率为53.8%,而最大径超过70 mm的患者完全消融率仅22.2%(P ＜ 0.01);肿瘤距离肝脏脏面≥ 10 mm和＜ 10 mm的患者完全消融率分别为83.7%和46.2%(P ＝ 0.01);单发肿瘤和多发肿瘤患者完全消融率分别为84.8%和50%(P ＝ 0.014).结论 肿瘤最大径是影响肝癌TACE后完全消融的重要因素.影响肿瘤完全消融的因素还包括肿瘤毗邻肝脏脏面,肿瘤多发等.

TACE combined with CT-guided percutaneous radiofrequency ablation for the treatment of primary hepatocellular carcinomas: an analysis of factors affecting the therapeutic result

Objective To investigate the factors affecting the complete ablation of primary hepatocellular carcinomas after the treatment of transcatheter arterial chemoembolization(TACE) combined with CT-guided percutaneous radiofrequency ablation.Methods A total of 62 cases with hepatocellular carcinoma were enrolled in this study.All the patients were treated with TACE,which was followed by CT-guided percutaneous radiofrequency ablation within one month after TACE.One month after the ablation, multiphase enhanced CT scan or MRI scan plus multiphase enhanced MRI scan was performed to evaluate the ablation degree of the tumors.Results The overall complete ablation rate was 79%,while the tumor residual rate was 21%.For the tumors with the maximum diameter<30 mm,30 - 50 mm,50 - 70 mm and>70 mm,the complete ablation rates were 100%,92.6%,53.8%and 22.2%,respectively(P<0.01 ).For the tumors being≥10mm and<10 mm apart from the liver visceral surface,the complete ablation rates were 83.7%and 46.2%,respectively(P = 0.01).The complete response rate of single tumor and multiple lesions were 84.8%and 50%,respectively(P = 0.014).Conclusion The maximum diameter of the tumor is the main factor affecting the complete ablation of the hepatic tumors after TACE.The location of the tumor(near the liver visceral surface) and multiple lesions are the other factors affecting the complete ablation.