肝动脉化疗栓塞联合经皮微波消融治疗中晚期肝癌的疗效评价

目的评价肝动脉化疗栓塞(TACE)联合经皮微波消融(microwave ablation)治疗中晚期肝癌的疗效及价值。资料与方法 68例中晚期肝癌患者,联合组37例先行TACE,再行微波消融治疗,对照组31例仅应用TACE治疗,全部病例于治疗前后行超声及动态增强CT或超声造影检查,观察患者肿瘤病灶大小变化及血流信号情况,同时检测治疗前后甲胎蛋白水平变化并随访患者生存率。结果联合治疗组部分缓解(PR)10例,稳定(SD)18例,进展(PD)9例,对照组PR 5例,SD 14例,PD 12例;联合治疗组在肿瘤血流信号消失、生存期及甲胎蛋白水平变化方面均优于对照组,其6个月、12个月、24个月生存率分别为100%、94.6%、78.4%,明显高于对照组的90.3%、74.2%、54.8%;Kaplan-Meier生存分析显示,联合治疗组的生存时间较对照组延长,差异有统计学意义。结论 TACE联合微波消融治疗中晚期肝癌具有协同作用,疗效明显并可延长患者生存期,是一种有效的微创综合治疗方法。

Evaluation on Curative Effect of TACE Combined with Microwave Ablation For Hepatic Cellular Carcinoma with Moderate and Advanced Stage

Objective To evaluate the curative effect and value of TACE combined with microwave ablation in the treatment of HCC with moderate and advanced stage.Materials and Methods68 patients with HCC were randomly divided into two groups.Combination group included 37 patients who were treated with TACE and microwave ablation,while control group included 31 patients,who were treated with TACE alone.68 patients were followed up 24 months with ultrasound,enhancement CT and contrast enhanced ultrasound to observe the size change of the lesions and the blood flow signal.Alpha fetoprotein were detected and the survival rate were followed up in pretherapy and posttherapy.ResultsIn combination group(37 patients) PR had 10 cases,SD had 18 cases,PD had 9 cases,while in control group(31 patients) PR had 5 cases,SD had 14 cases,PD had 12 cases.The combination group had advantage over the control group in the vanish of blood flow signal and the survival rate.The combination group survival over 6 months,12 months,24 months accounted for 100%,94.6%、78.4%,,while the control group for 90.3%,74.2%,54.8%.Kaplan Meier survival analysis indicated that the live time of combination group was longer compared with control group and the difference had statistical significance.ConclusionMicrowave ablation combined with TACE has joint action,it can improve the curative effect and increase the patients’survival rate,which is a valuable microinvasive method for HCC.