肝动脉化疗栓塞联合射频消融治疗大肝癌的疗效评价

目的探讨经导管肝动脉化疗栓塞（transcatheter arterial chemoembolization,TACE）联合射频消融（radiofrequency ablation,RFA）治疗大肝癌的临床应用价值。方法回顾性分析我院2006年4月至2008年7月收治的66例肝细胞癌患者的治疗结果,根据治疗方法分为TACE＋RFA组、TACE组及RFA组,其中19例行RFA联合TACE治疗（TACE＋RFA组）,24例单纯TACE治疗（TACE组）,23例单纯RFA治疗（RFA组）。结果 TACE＋RFA组的肿瘤坏死率达73.68%,明显高于单纯TACE组及单纯RFA组（分别为50.00%,52.17%,P〈0.01,P〈0.05）。局部复发率分别为26.32%、37.50%和30.43%,三组间无显著统计学差异（P〉0.05）。TACE＋RFA组的平均生存期为28.3个月,显著高于TACE组的13.6个月（P〈0.01）和单纯RFA组的21.7个月（P〈0.05）。结论 TACE联合RFA治疗大肝癌与单纯TACE和单纯RFA治疗效果相比,可提高肿瘤坏死率,延长患者生存期。

Transcatheter arterial chemoembolization combined with radiofrequency ablation in treatment of large hepatocellular carcinoma

Objective To evaluate the efficacy of tanscatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in treatment of large hepatocellular carcinoma.Methods A retrospective analysis was performed of 66 patients with hepatocellular carcinoma who received different treatments during April 2006-July 2008.The patients were divided into 3 groups:19 patients in TACE + RFA group,24 patients in TACE group,and 23 patients in RFA group.Results The complete necrosis rate of tumor accounted for 73.68% in TACE + RFA group which was significantly higher than that of TACE group and RFA group(50.00%,and 52.17%,respectively,P < 0.01,P < 0.05).The local recurrence rates of tumor in TACE + RFA group,TACE group,and RFA group were 26.32%,37.5% and 30.43%(P > 0.05).Mean survival time of patients in TACE + RFA group was 28.3 months,which was higher than that of TACE group and RFA group(13.6 months,21.7 months,P < 0.01,P < 0.05).Conclusion Percutaneous transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in primary large hepatocellular carcinoma could improve tumor complete necrosis rate and extend the patient’s survival time.