射频消融联合经导管肝动脉化疗栓塞术治疗原发性肝癌

目的 探讨经导管肝动脉化疗栓塞术(TACE)联合射频消融对原发性肝癌的治疗效果.方法 将经病理、影像学诊断及AFP值证实的原发性肝癌符合筛选条件的患者共80例,按住院号数的单、双数分成两组:对照组(TACE组)42例,综合治疗组(TACE+射频消融组)38例.对照组只给予TACE治疗,综合治疗组先行TACE后2～3周再予联合射频消融治疗.两组患者行TACE术时对肝动静脉瘘、门静脉癌栓及下腔静脉病变等并发症给予相应处理.结果 TACE组治疗42例患者,1、2、3年生存率分别为72%、55%和21%,中位生存期1.78年;综合治疗组38例患者1、2、3年生存率分别为89%、78%和53%,中位生存期2.31年.综合治疗组的生存率及生存期均显著高于TACE组(P＜0.05).综合治疗组的综合介入治疗效果与死亡风险率呈显著的负相关(OR=0.570,P＜0.05).结论 TACE联合射频消融对原发性肝癌的治疗可显著提高原发性肝癌的生存率,延长生存期.

RFA and TACE for treatment of hepatocellular carcinoma

Objective To investigate the effectiveness of therapy combinated TACE and RFA in the treatment of hepatocellular carcinoma. Methods We collected 80 cases of hepatocellular carcinoma in which the diagnosis was confirmed by pathology, radio-imaging and AFP value. The patients were divided into 2 groups by odd or even hospitalization number. A total of 42 patients were enrolled in the TACE only group and 38 patients were enrolled in the combination therapy group. Patients in the combination therapy group underwent the TACE procedure with another physical ablation technique. Complications were treated properly, such as hepatic arteriovenous fistula, portal vein cancer embolism, pathological changes of inferior cava,etc. Results For the 42 patients in TACE only therapy group, the survival rates of 1, 2 and 3 year were 72%, 55% and 21%, respectively, with a median survival of 1. 78 years. For patients in the combination therapy group, survival rates of the 1, 2 and 3 year were 89%, 78% and 53% , respectively,with a median survival of 2. 31 years. Survival rate and duration in the combination therapy group was significantly greater in the combination therapy group compared to the TACE group (P＜0. 05). There was a negative correlation between the effectiveness of combination therapy and the mortality risk(OR=0. 570,P＜0. 05). Conclusion Combination therapy can significantly increase survival rate and prolong survival time in patients with hepatocelluar carcinoma.