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1.
目的探讨肝动脉化疗栓塞(TACE)联合射频消融(RFA)治疗中晚期肝癌的临床疗效。方法62例具有介入治疗指征的中晚期肝癌患者随机均分为2组,对照组31例单独行TACE治疗,观察组31例行TACE联合RFA治疗。比较观察2组的临床疗效及AFP水平。结果观察组总有效率为87.1%,高于对照组的51.6%(P〈0.05)。观察组术后AFP水平明显低于对照组(P〈0.05)。随访24个月各时期的生存率观察组均明显高于对照组(P〈0.05)。结论TACE联合RFA治疗中晚期肝癌安全、可靠,可提高患者生存率,延长患者生存时间,疗效优于单独应用TACE。  相似文献   

2.
Purpose: To evaluate efficacy of transarterial chemoembolization (TACE) combined with radiofrequencyablation (RFA) in treatment of patients with hepatocellular carcinoma. Materials and Methods: During January2009 to March 2012, 80 patients with hepatocellular carcinoma underwent TACE, with or without RFA. Alfafetoprotein(AFP) was checked before and after procedure. CT scans were obtained one month after TACE or RFAfor all patients to evaluate tumor changes. Complete response+partial response+stable disease (CR+PR+SD)/nwere used to assess the disease control rate (DCR). Survival at 3, 6 and 12 months was compared in both groups.Results: AFP levels in TACE + RFA group dropped rapidly, becoming obviously lower than that of the TACEgroup. In the TACE + RFA group DCR was 93.8%, while only 76.8% in the TACE group. The treatment effectbetween the two groups was statistically significant (P<0.05) by Ridit analysis. 1 year survival rate in the TACE+ RFA group was 92.5%, significantly higher than that of the TACE group at 77.5% (P<0.05). Conclusions:TACE and RFA as combined therapy method for patients with middle and terminal stage HCC gives full playto synergy between the two and improves the therapeutic effect.  相似文献   

3.
Zhang FJ  Wu PH  Zhao M  Gu YK  Zhang L  Tan ZB 《中华肿瘤杂志》2005,27(4):248-250
目的 探讨肝动脉栓塞化疗(TACE)后,CT导向下射频消融(RFA)联合无水乙醇消融(PEI)对原发性肝癌(HCC)的治疗效果。方法 经病理、AFP或典型影像学诊断证实的HCC 1 5 0例,每例肝内的病灶数目<3个,病灶大小3.1~7.9cm ,平均直径5 .5cm。全部患者按就诊单双日分为对照组和联合组。对照组74例,TACE后2周行单纯RFA ;联合组76例,TACE后2周行射频消融,间隔2 0~30d后再行PEI。结果 对照组的完全坏死率为75 .8%,联合组为89.5 %,两组间差异有统计学意义(P <0 .0 5 )。结论 HCC患者经TACE后,行CT导向下RFA联合PEI的疗效明显优于单纯RFA。  相似文献   

4.
Objective:To evaluate the clinical efficacy of the combined treatment with transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) on hepatocellular carcinoma (HCC). Methods:312 patients with moderate or advanced HCCs were divided into two groups: 170 cases underwent TACE treatment alone, 142 cases were treated with TACE and PEI under B-ultrasotmd guidance. Results:The rates of reduction in tumor diameter and the decline in serum AFP level were 41.2% and 40.4% in the TACE group and 75.4% and 74.1% in the TACE PEI group respectively. The 6, 12 and 24 months survival rates in the TACE group were 77.1%,34.1% and 18.8%,respectively and in the TACE PEI group 87.3%, 62.0% and 38.0%, respectively. Overall, there was a significant difference between the two treatment groups (P<0.05). Conclusion:Treatment on HCCs with TACE PEI is convenient, safe and results in better survival rates than TACE alone.  相似文献   

5.
The aim of this study is to compare the overall survival in patients with hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) versus RFA alone. All eligible studies were collected from the PubMed, the Cochrane Library, and the Embase electronic databases. The outcomes were overall survival rates. We used odds ratios to assess the strength of the association, and 95 % confidence intervals give a sense of the precision of the estimate. Statistical analyses were performed by Review Manager 5.0 and Stata 11.0. A total of 19 available studies were considered in the present meta-analysis. When all groups were pooled, meta-analysis showed that RFA plus TACE significantly improved the survival rates of patients with HCC at 1, 3, and 5 years compared with RFA alone. The combination of RFA with TACE has advantages in improving overall survival rate, and provides better prognosis for HCC patients.  相似文献   

6.
Li C  Shi Z  Hao Y 《中华肿瘤杂志》2001,23(6):490-492
目的 研究B超引导下经皮肝穿刺注射无水乙醇(percutaneous ethanol injection,PEI)配合肝动脉化疗栓塞术(transcatheter hepatic arterial chemoembolization,TACE)治疗原发性肝癌的疗效。方法 原发性肝癌87例,其中TACE组45例,TACE+PEI组42例。结果 TACE组1,2,3年生存率分别为66.7%、41.2%和21.4%,组织学检查仅26.1%的病变完全坏死;TACE+PEI组1,2,3年生存率分别为97.1%、85.7%和65.7%,组织学检查81.8%的病变完全坏死。两组间在生存率和肿瘤完全坏死率间差异均有显著性(P<0.05)。结论 对于原发性肝癌,TACE+PEI疗效优于单纯TACE,是一种较好的综合治疗方法。  相似文献   

7.
To assess the evidence for improved outcomes in hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) plus percutaneous ethanol injection (PEI). A systematic search of MEDLINE, EMBASE, the Cochrane library, Chinese biomedicine literature database, Chinese scientific full-text database, and Chinese journal full-text database was undertaken for relevant articles. The computer search was supplemented with a manual search of reference lists for all available review articles, primary studies, and books to identify other studies not found in the computer search. The initial search identified seven randomized trials that included 623 patients. Meta-analysis results are as follows: the 6-month, 1-, 2-, and 3-year survival rates were significantly better in patients with the TACE + PEI group than TACE group; in the decline rates of the AFP level and the reduction rates of tumor size (>50%), the TACE + PEI group has better effects than TACE group; as adverse effects, TACE + PEI group has lower incidence rates than TACE group. In patients with HCC, the efficacy of TACE combined with PEI is significantly better than that of TACE alone. Although there is convincing evidence to confirm the results mentioned, they still need to be confirmed by large sample, multicenter, randomized, controlled trials.  相似文献   

8.
目的 :探讨双介入方法治疗原发性肝癌的应用价值。方法 :选择 1999年 8月 - 2 0 0 1年 10月进行介入治疗的原发性肝癌患者 6 5例 ,其中单纯行TACE 34例 (TACE组 ) ,行TACE和PEI双介入治疗31例 (双介入组 )。全部病例定期做CT检查和AFP测定 ,观察肿瘤客观疗效。结果 :TACE组肿瘤客观有效率 (CR +PR) 35 3% ,AFP下降幅度 5 6 1% ,2年生存率 5 0 % ;双介入组客观有效率 6 4 5 % ,AFP下降幅度 78 6 % ,2年生存率 6 1 3% :2组间差异有显著意义 ,P <0 0 5。结论 :双介入方法治疗原发性肝癌疗效肯定 ,优于单纯应用TACE。  相似文献   

9.
术后复发性肝癌的介入治疗疗效分析   总被引:4,自引:1,他引:3  
Ge NL  Ren ZG  Ye SL  Lin ZY  Xia JL  Gan YH  Li LX  Shen YF  Tang ZY 《中华肿瘤杂志》2005,27(6):380-382
目的分析肝动脉化疗栓塞(TACE)治疗术后复发性肝细胞肝癌的生存率及影响因素。方法对行TACE治疗的130例术后复发性肝细胞肝癌患者进行回顾性分析,计算此类患者治疗后的生存率及生存时间,分析影响其生存的相关因素。结果全组130例总的1,3,5年生存率为83.0%、45.5%和17.6%,中位生存时间2.4年。单纯TACE治疗94例,其1,3年生存率分别为76.4%和37.1%,中位生存期2.1年;TACE联合瘤内无水酒精注射(PEI)治疗36例,1,3年生存率分别为100.0%和66.5%,中位生存期为3.5年。TACE联合PEI治疗组的生存率和生存期均显著优于单纯TACE治疗组(P<0.05),死亡风险显著低于单纯TACE治疗组(P<0.05);复发瘤直径>5cm和有远处转移者的死亡风险,显著高于肿瘤直径≤5cm和无远处转移者(P<0.05)。结论TACE联合PEI治疗,可显著提高术后复发性肝癌患者的生存率,延长生存期。  相似文献   

10.
Objective:To compare radiofrequency ablation (RFA) or microwave ablation (MWA) and transcatheter arterial chemoembolization (TACE) with RFA or MWA monotherapy in hepatocellular carcinoma (HCC).Methods:A prospective,randomized,controlled trial was conducted on 94 patients with HCC ≤7 cm at a single tertiary referral center from June 2008 to June 2010 at the Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Southeast University.The patients were randomly assigned into the TACERFA or TACE-MWA (combined treatment group) and the RFA-alone or MWA-alone groups (control group).The primary end point was overall survival.The secondary end point was recurrence-free survival,and the tertiary end point was adverse effects.Results:Until the time of censor,17 patients in the TACE-RFA or TACE-MWA group had died.The median follow-up time of the patients who were still alive for the TACE-RFA or TACE-MWA group was 47.5±11.3 months (range,29 to 62 months).The 1-,3-and 5-year overall survival for the TACE-RFA or TACE-MWA group was 93.6%,68.1% and 61.7%,respectively.Twenty-five patients in the RFA or MWA group had died.The median follow-up time of the patients who were still alive for the RFA or MWA group was 47.0±12.9 months (range,28 to 62 months).The 1-,3-and 5-year overall survival for the RFA or MWA group was 85.1%,59.6% and 44.7%,respectively.The patients in the TACE-RFA or TACE-MWA group had better overall survival than the RFA or MWA group [hazard ratio (HR),0.526; 95% confidence interval (95% CO,0.334-0.823; P=0.002],and showed better recurrence-free survival than the RFA or MWA group (HR,0.582; 95% CI,0.368-0.895; P=0.008).Conclusions:RFA or MWA combined with TACE in the treatment of HCC ≤7 cm was superior to RFA or MWA alone in improving survival by reducing arterial and portal blood flow due to TACE with iodized oil before RFA.  相似文献   

11.
Chen XM  Luo PF  Lin HH  Zhou ZJ  Shao PJ  Fu L  Li WK 《癌症》2004,23(7):829-832
背景与目的肝癌的介入治疗中,经导管肝动脉化疗栓塞(transcatheterarterialchemoembolization,TACE)与经皮无水乙醇注射(percutaneousethanolinjection,PEI)是开展最广泛、效果最显著的两项治疗措施。TACE联合PEI可明显提高肝癌的近效疗效,但远期随访结果报道较少。本研究拟探讨TACE联合PEI治疗肝癌的长期效果及价值。方法675例肿瘤直径为2~15cm(平均9.6cm)、不能切除的原发性肝细胞癌(hepatocellularcarcinoma,HCC)接受介入治疗,其中179例行TACE联合PEI治疗(联合组),496例行单纯TACE治疗(TACE组)。两组中各有10例介入治疗后行Ⅱ期手术切除,标本送病理研究。其他病例随访5~7年以上(平均6.6年),分别统计1、3、5、7年累计生存率。联合组与TACE组两组无论是手术切除病例,还是随访病例,介入治疗前的一般资料均具有可比性。结果病理研究显示,虽然治疗前后肿块缩小程度两组无显著性差异,但联合组肿瘤平均坏死程度[(100.0±0.0)%]及完全坏死率(100%)均显著高于TACE组[分别为(91.5±7.1)%和20%,P<0.05或0.01]。随访结果显示,联合组1、3、5、7年生存率分别为80.5%、58.6%、29.6%和16.5%,TACE组分别为68.5%、27.8%、7.2%和5.2%,统计学处理均有显著性差异(P<0.01)。结论TACE联合PEI是提高HCC远期生存率较好的治疗  相似文献   

12.
Objective: To observe the clinical effect of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) for advanced hepatocellnlar carcinoma (HCC). Methods: A total of 92 eases of advanced primary liver cancer underwent TACE and RFA treatment from June 2005 to 2011 at the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College. A total of 88 cases with complete clinical treatment and follow-up data were divided into two groups: 43 patients treated with TACE (TACE group) and 45 patients that received TACE combined with RFA treatment (TACE + RFA group). After clinical data assessment, tumor size and survival status were not significantly different between the groups as determined by stratified analysis. Results: Before and after surgery, spiral CT radiography and color comparison observed ablation conditions. The tumor necrosis rates after treatment (CR + PR) were 67.4% (29/43) and 91.1% (41/45) for the TACE and combined treatment groups, respectively, and the difference was statistically significant (P〈0.05). The quality of life was significantly improved for patients undergoing TACE ~ RFA compared with the control group. Survival duration was not significantly different in patients undergoing TACE ~ RFA compared with the control group. Conclusions: In this study, the effect of RFA combined with TACE treatment was better than TACE alone in treating advanced HCC.  相似文献   

13.
Introduction: Local ablative therapy and trans arterial chemoembolization (TACE) are applied to ablate non resectable hepatocellular carcinoma (HCC). Combination of both techniques has proven to be more effective. We aimed to study combined ablation techniques and assess survival benefit comparing TACE with radiofrequency (RFA) versus TACE with microwave (MWA) techniques. Methods: We retrospectively studied 22 patients who were ablated using TACE-RFA and 45 with TACE-MWA. All were classified as Child A-B and lesions did not exceed 5 cm in diameter. TACE was followed within two weeks by either RFA or MWA. We recorded total and partial ablation rates and complication rates. Survival analysis was then performed. Results: TACE-MWA showed a higher tendency to provide complete response rates than TACE-RFA (P 0.06). This was particularly evident with lesions sized 3-5 cm (P 0.01). Rates of complications showed no significant difference between the groups. Overall median survival was 27 months. The overall actuarial probability of survival was 80.1% at 1 year, 55% at 2 years, and 36.3% at 3 years. The recurrence free survival at 1 year, 2years and 3 years for the TACE-RFA group was 70%, 42% and 14% respectively and for TACE-MWA group 81.2%, 65.1% and 65.1% without any significant difference (P 0.1). In relation to the size of focal lesions, no statistically significant difference in the survival rates was detected between the groups. Conclusion: TACE-MWA led to better response rates than TACE-RFA with tumors 3-5 cm, with no difference in survival rates.  相似文献   

14.
M Koda  Y Murawaki  A Mitsuda  K Oyama  K Okamoto  Y Idobe  T Suou  H Kawasaki 《Cancer》2001,92(6):1516-1524
BACKGROUND: To assess whether the effectiveness of a combination of transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) is superior to PEI alone in the treatment of patients with small hepatocellular carcinoma (HCC), a randomized controlled study was performed. METHODS: Fifty-two patients with one to three HCC tumors measuring < than 3 cm in greatest dimension were enrolled and underwent the combination TACE-PEI therapy (26 patients with 31 nodules) or PEI alone (26 patients with 34 nodules). There were no significant differences in background between the two groups. The mean follow-up was 30.1 months +/- 17.5 months. RESULTS: The cumulative detection rates of local residual disease in the TACE-PEI group (3.7% at 1 year and 19.3% at 3 years) were significantly lower compared with the detection rates in the PEI alone group (34.2% and 39.3%, respectively; P = 0.013). The cumulative new nodular recurrence rates in the TACE-PEI group (8.7% at 1 year and 19.3% at 3 years) tended to be lower compared with the recurrence rates in the PEI alone group (26.9% and 80.1%, respectively; P = 0.057). The cumulative survival rates were not significantly different between the two groups (TACE-PEI group: 100%, 80.8%, and 40.4% at 1 year, 3 years, and 5 years, respectively; PEI alone group: 91.3%, 65.9%, and 37.7%, respectively; P = 0.458). However, among the patients from each group with HCC tumors measuring < 2 cm, the survival rates in the TACE-PEI group were improved compared with the survival rates in the PEI alone group (P < 0.01) in addition to the detection rates of local residual disease and the new nodular recurrence rates (P < 0.01 and P = 0.047, respectively). The frequency of short-term and long-term adverse effects was not significantly different between the groups. However, only two major complications (biloma and ascites with pleural effusion) were observed, both of which occurred in patients in the TACE-PEI group. CONCLUSIONS: Combination therapy with TACE-PEI was superior to PEI alone in the treatment of patients with small HCC tumors, especially for patients with HCC tumors measuring < 2 cm in greatest dimension.  相似文献   

15.
Objective: This study evaluated the therapeutic effect of external beam radiotherapy(RT)combined with transcatheter arterial chemoembolization(TACE)on the patients with unresectable hepatocellular carcinoma(HCC).Methods: From June 1994 to April 2002, 114 patients with unresectable HCC were nonrandomized prospectively stepped into our study.All patients received TACE as initial therapy, except 54 also received combination therapy with external beam therapy.Survival failure patterns were analyzed and compared between the two groups.Results: Overall survival rates in the patients in the radiotherapy group were 65%, 47%, 38% at 1, 2, 3 years, respectively, improved over the non-radiotherapy group rates of 54%, 36.5%, 18% at 1, 2, 3 years, respectively.There was significant difference between two groups(P<0.05).The survival rates correlated with tumor size, number of tumors, and portal vein embolus.Conclusion: TACE combined with RT is a more effective treatment than TACE alone in patients with unresectable HCC.  相似文献   

16.
The aim of this study was to compare the effectiveness of combination of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) with that of RFA alone in patients with hepatocellular carcinoma (HCC). All possible trials comparing RFA plus TACE with RFA alone for HCC were included into this meta-analysis. We estimated the summary odds ratio (OR) with its 95 % confidence interval (95 % CI) to assess the effects. Nineteen eligible studies matched the selection criteria, including 1,728 patients. Meta-analysis showed that the combination of TACE and RFA (OR1 year?=?2.14, 95 % CI?=?1.57–2.91, P?<?0.001; OR3 years?=?1.98, 95 % CI?=?1.28–3.07, P?=?0.001; OR5 years?=?2.70, 95 % CI?=?1.42–5.14, P?=?0.003) were associated with higher survival rates. No evidence of publication bias was observed. High-quality evidence suggests that TACE plus RFA improve the survival rates compared with RFA alone for patients with HCC.  相似文献   

17.
目的 比较无水酒精注射((percutaneous ethanol injection,PEI)联合经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)与单纯PEI治疗小肝癌的疗效。方法 回顾性分析我院2008年10月至2014年12月收治的50例小肝癌患者的临床资料。50例中41例行PEI联合TACE,9例行单纯PEI。比较两组术后甲胎蛋白(alpha fetoprotein,AFP)变化及术后1年、2年、3年生存情况。结果 PEI联合TACE组术后AFP转阴率为66.67%、AFP下降率为90.48%,术后1年、2年、3年生存率分别为87.80%、80.49%和75.61%。单纯PEI组术后AFP转阴率为14.29%、AFP下降率为71.43%,术后1年、2年、3年生存率分别为77.78%、55.56%和33.34%。PEI 联合TACE组AFP转阴率、术后3 年生存率高于单纯PEI组(P<0.05)。结论 PEI联合TACE治疗小肝癌疗效优于单纯PEI,有临床应用价值。  相似文献   

18.
目的:探讨经导管肝动脉化疗栓塞(TACE)联合序贯射频消融术(RFA)治疗大肝癌患者的疗效及复发因素。方法:选取我院2013年1月-2015年1月肿瘤外科中晚期原发性大肝癌患者110例并分为肝动脉化疗栓塞组(TACE 组)与肝动脉化疗栓塞联合序贯经皮射频消融术组(TACE +RFA 组)各55例,TACE 组患者行一次或多次单一肝动脉化疗治疗;TACE +RFA 组在肝动脉化疗治疗结束后1~2周再行序贯经皮射频消融术治疗。结果:TACE 组与 TACE +RFA 组总有效率分别为63.64%(35/55)、94.54%(52/55)。TACE +RFA 组1年生存率为72.7%(40/55),2年生存率为20.0%(11/55),而 TACE 组分别为56.36%(31/55)、7.27%(4/55)。Log -rank 检验结果显示肿瘤数量、分期、血清甲胎蛋白水平等为大肝癌患者预后的因素,与患者预后有一定关系。结论:经导管肝动脉化疗栓塞(TACE)联合经皮射频消融术(RFA)治疗原发性中晚期大肝癌可以有效提高患者生存率,延长患者的生存期。肿瘤数量、直径、分期等是影响患者复发的危险因素。  相似文献   

19.
 目的 观察经皮肝动脉化疗栓塞(TACE)和CT引导下经皮穿刺瘤内无水酒精(PEI)序贯性治疗巨块型原发性肝癌的疗效。方法 144例无远处转移巨块型原发性肝癌先经TACE术治疗,2周后再进行4 ~ 6次PEI治疗。结果 PR 96例(66.7 %),MR 33例(22.9 %),SD 15例(10.4 %),二期可切除69例,手术切除率47.9 %。随访结果显示:6个月、1、2、3年生存率分别为:93.8 %、75.0 %、59.0 %、31.9 %。结论 TACE与PEI序贯性治疗中晚期巨块型肝癌疗效较显著,使原不能手术切除的肝癌可以适应手术治疗,延长了患者的生存期,提高了患者生活质量  相似文献   

20.
射频消融治疗原发性肝癌的生命质量对比评价   总被引:3,自引:0,他引:3  
Wang YB  Chen MH  Yan K  Yang W  Dai Y  Yin SS 《癌症》2005,24(7):827-833
背景与目的以往对原发性肝癌(hepatocellularcarcinoma,HCC)各种治疗疗效的评价主要从治愈率、生存率和生存时间方面进行,近年来生命质量(qualityoflife,QOL)研究倍受关注,能较全面地反映肝癌患者体能恢复状况和切身感受而被广泛应用于癌症、慢性病的疗效评价。目前对于经皮射频消融(radiofrequencyablation,RFA)、经动脉插管栓塞化疗(transcatheterhepaticarterialchemo-embolization,TACE)治疗意义的评价大多关注局部肿瘤灭活率及患者生存率,而对治疗后患者生命质量的研究尚不多见。本研究从患者整体角度对比评估原发性肝癌经皮射频消融治疗后患者的生命质量。方法采用国内肝癌特异性生命质量量表(QOL-LCV2.0),对80例HCC经RFA治疗后QOL进行评定;并与同期40例经动脉插管栓塞化疗(TACE组)以及TACE RFA(联合组)40例分别进行比较。3组患者在年龄、性别、临床分期等方面分布均衡,无明显差异。结果RFA组的QOL总分中位数(168.6)高于TACE组(146.8),差异有显著性(P=0.025);RFA组和联合组在症状/副作用领域的得分中位数45.5、46.0,分别优于单纯TACE组38.1(P<0.01);RFA组躯体功能领域得分呈略高于TACE组的趋势。患者的年龄、收入、治疗后Child-Pugh分级、治疗后新生/复发率、并发症等方面与患者生命质量相关。TACE组和联合组于治疗后Child-Pugh分级提高的比例分别高于RFA组;TACE组新生/复发的比例明显高于RFA组。RFA组的1年、2年和3年生存率(92.8%、89.3%和76.5%)与联合治疗组(94.1%、87.4%、60.0%)比较无统计学差异,但高于TACE组(74.3%、48.2%、48.2%)。结论RFA治疗肝癌,多数患者可获得较好的疗效,严重的副作用少。TACE与RFA联合治疗与单纯TACE相比,可减少患者肝功能损伤,有利于提高原发性肝癌患者的生命质量。  相似文献   

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