经导管动脉化疗栓塞术联合经皮微波消融治疗大肝癌

目的探讨TACE联合经皮微波消融治疗(PMCT)对原发性大肝癌(直径5～10cm)的临床疗效及安全性。方法将我院收治的102例中晚期原发性大肝癌患者随机分为TACE组(n=42)及联合治疗组(TACE+PMCT组,n=60),均予一次或多次TACE,对TACE+PMCT组1～2周后给予微波消融治疗。治疗结束后进行随访,评价两组的治疗效果及并发症。结果两组均未发生严重并发症。TACE+PMCT组完全缓解率、部分缓解率及AFP下降率均高于TA-CE组(P=0.030、0.024、0.020),其1、2年生存率亦均高于TACE组(P=0.007、0.001)。TACE+PMCT组与TACE组的中位生存时间分别为19个月和13个月(P<0.001)。结论 TACE联合PMCT治疗原发性肝癌可明显延长患者生存期和提高生存率。

TACE combined with percutaneous microwave ablation in treatment of large primary hepatocellular carcinoma

Objective To investigate the effectiveness and safety of TACE in combination with percutaneous microwave coagulation therapy（PMCT） in treatment of large hepatocellular carcinoma（5—10 cm）.Methods Totally 102 patients of large hepatocellular carcinoma were randomly divided into 2 groups.A total of 42 patients were enrolled in TACE group,and 60 patients were enrolled in the synthetic therapy group（TACE＋PMCT group）.Both groups were given conventional TACE for once or several times.After TACE,PMCT was performed in TACE＋PMCT group within 1—2 weeks.Then follow-up was done,and the therapeutic effect and complication in both groups were evaluated.Results The partial response rate,complete response rate and the descent rate of AFP for the TACE＋PMCT group were higher than those of the TACE group,respectively（P=0.030,0.024,0.020）.The 1-and 2-year survival rate in TACE＋PMCT group were also higher than those in TACE group（P=0.007,0.001）,with the median survival time was 19 months and 13 months in TACE＋PMCT group and TACE group,respectively（P=0.007,0.001）.No severe complications occurred.Conclusion TACE combined with PMCT can significantly increase survival rate and survival period in patients with hepatocellular carcinoma.