经肝动脉化疗栓塞联合射频消融术对中晚期原发性肝癌的近期疗效分析

目的探讨经肝动脉化疗栓塞(TACE)联合经皮肝穿刺射频消融术(RFA)治疗中晚期原发性肝癌(PHC)的临床疗效和安全性。方法将125例中晚期PHC患者按治疗方法不同分为TACE组(40例)、RFA组(38例)及TACE+RFA组(47例),观察3组近期疗效和并发症发生情况;采用Kaplan-Meier法计算复发率、生存率及中位生存期,比较采用Log-Rank时序检验。结果 TACE+RFA组总有效率为74.5%,明显高于TACE组的52.5%和RFA组的47.4%(P0.05);TACE+RFA组1、2年复发率分别为17.0%、31.9%,均明显低于TACE组(37.5%、57.5%)和RFA组(42.1%、60.5%)(P0.05);TACE+RFA组1、2年生存率分别为89.4%、70.2%,均明显高于TACE组(70.0%、47.5%)和RFA组(68.4%、44.7%)(P0.05);且TACE+RFA组中位生存期(26个月)明显长于TACE组(21个月)和RFA组(19个月)(P0.05)。结论 TACE联合RFA可有效治疗中晚期PHC,减少术后复发率并提高生存率,延长患者生存期,其疗效优于单纯TACE或单纯RFA治疗。

Therapeutic effects of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of advanced primary hepatocellular carcinoma

Objective To investigate the therapeutic effects and safety of transcatheter arterial chemoembo-lization (TACE) combined with percutaneous radiofrequency ablation (RFA) in the treatment of advanced primary hepatocellular carcinoma (PHC). Methods A total of 125 cases of patients with advanced PHC were divided into the TACE group (n=40), RFA group (n=38) and TACE+RFA group (n=47) according to the different therapeutic methods. The short-term efficacy and complications of the three groups were observed. The recurrent rate, survival rate and median survival time (MST) were calculated by Kaplan-Meier method, and the differences among the three groups were analyzed by Log-Rank test. Results The total effective rate of the TACE+RFA group was 74.5%, which was obviously higher than those of the TACE group (52.5%) and the RFA group (47.4%) (P<0.05). The 1- and 2-year recurrent rates of the TACE+RFA group were 17.0% and 31.9%, respec-tively, which were both significantly lower than those of the TACE group (37.5% and 57.5%) and the RFA group (42.1% and 60.5%) (P<0.05). Moreover, the 1- and 2-year survival rates of the TACE+RFA group were 89.4%and 70.2%, respectively, which were both evidently higher than those of the TACE group (70.0% and 47.5%) and the RFA group (68.4% and 44.7%) (P<0.05). Additionally, the MST of the TACE+RFA group (26 months) was observably longer than those of the TACE group (21 months) and the RFA group (19 months) (P<0.05). Conclu-sion The therapy of TACE combined with RFA can improve the survival rate and prolong the survival time of advanced PHC patients, and it has a better therapeutic effect on advanced PHC than that of single TACE or single RFA.