高危部位肝癌射频消融治疗的进展

射频消融(RFA)是目前不能手术的肝恶性肿瘤患者的有效局部治疗方法之一。对于不易消融的高危病灶,如邻近膈肌、消化道、肝门大血管或胆管及肝包膜的病灶,由于无法清晰分辨病灶及容易损伤紧邻组织器官,RFA的严重并发症发生率高、局部复发率高,且死亡率增加。目前高危部位肝癌RFA治疗有诸多探索,包括联合辅助技术、采用新的引导技术、联合其他局部治疗,以期在保证安全治疗的同时提高疗效。这些探索有望增加高危部位RFA的治疗指征,使更多患者获益。本文主要对高危部位肝恶性肿瘤的射频消融治疗进展作一综述。

The development of radiofrequency ablation of hepatic carcinoma in high-risk locations

Radiofrequency ablation （RFA） is one of the effective local therapies for hepatic carcinoma. High-risk locations, such as foci abutting diaphragm, gastrointestinal tract, porta blood vessel or bile duct, hepatic subcapsule, will lead to increased severe complication rate, local tumor recurrence （LTR） and mortality due to poor lesion identification or concurrent thermal injury to contiguous organs. There are several new therapeutic options developed recently, including combined adjuvant therapies, new guiding technology and combined other local therapies, which may increase the indications of RFA at high-risk locations, and benefit more patients. This article reviewed the new development of RFA technologies for high-risk locations of hepatic carcinoma.