原发性及转移性肝癌的射频治疗

目的：探讨射频（RFA）治疗肝癌的疗效及安全性，方法：对前瞻性非随机性选择的102例肝癌病人射频治疗的临床资料进行分析。结果：102例病人共216个肿瘤，肿瘤直径1．5－14cm，平均4．9cm，原发性肝癌67例，其中＜5．0cm肝癌21例，继发性肝癌35例，超声引导下穿刺地RFA 43例，CT引导下的RFA 50例，腹腔镜下穿刺RFA 3例，开腹术中直视下RFA 6例，所有病例术后30d复查肝脏彩色多普勒;血流显像，见原肿瘤回声较术前增强，范围增大，肿瘤内血流明显减少或消失；CT见原肿瘤阴影密度降低，14例病人术后20－30d行FDG－PET显像，11例显示肝内原肿瘤部位呈放射性分布缺损区，3例病人见有部分肿瘤残留，其中2例经再次RFA后，残余肿瘤完全被杀灭，另1例病人由于年龄较大，即予残瘤内无水酒精注射，所有病人均获随访，随访时间3－18个月，除初期6例晚期转移性肝癌病人由于未有控制病情发展于术后1年内死亡外，其余病人现均存活，1年顾活率94．1％，结论：RFA是一种安全，有效，创伤小，耐受性好的治疗肝癌的新方法。

Radiofrequency ablation for primary and metastatic hepatic cancer

Objective To study the effect and safety of radiofrequency ablation (RFA) in the treatment of liver cancer.Methods The clinical data of prospectively and non-randomly selected 102 liver cancer patients were analysed. Results 102 patients with a total of 216 tumors were found in this series, the size of hepatomas were 1.5 to 14*!cm in diameter (average 4.9*!cm in diameter). In 67 of primary liver hepatocellular carcinoma, the tumors' size were smaller than 5*!cm in diameter in 21 cases; 35 with secondary liver tumors. RFA were performed under the guidance of ultrasonography in 43 cases, under CT in 50, under laparoscopy in 3, and 6 were performed during open surgery. All patients received ultrasonography and CT scanning of liver one month after the ablaton. The echoes of the tumors were stronger, and the area of the echo reached was larger than pre-ablation; blood flow in the tumor obviously reduced and even disappeared in sonography; CT showed that the shadow density in the tumor was diminished. Of the 102 patients, 14 underwent 18-FDG-PET imaging 30 days after the ablation, of them, 11 showed defect of radiation in the tumor, 3 showed residual locus in the tumor. 2 of the 3 cases underwent RFA again and the residual was disappeared completely, the another subject to ethanol injection because of advanced age. All the patients were followed up for 3-18 months. Except 6 patients with late metastastic liver cancer died within 1 year after RFA, the other 96 cases remained alive now, the 1-year survival rate was 94.1%. Conclusions RFA is a new ideal therapy for liver cancer. It is safe, effective, and good tolerance with little trauma.