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小肝细胞癌:射频消融与经皮微波凝固治疗的比较

Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy.

作者信息

Shibata Toshiya, Iimuro Yuji, Yamamoto Yuzo, Maetani Yoji, Ametani Fumie, Itoh Kyo, Konishi Junji

机构信息

Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyoku, Kyoto 606-8507, Japan.

出版信息

Radiology. 2002 May;223(2):331-7. doi: 10.1148/radiol.2232010775.

Abstract

PURPOSE

To evaluate the effectiveness of radio-frequency (RF) ablation and percutaneous microwave coagulation (PMC) for treatment of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Seventy-two patients with 94 HCC nodules were randomly assigned to RF ablation and PMC groups. Thirty-six patients with 48 nodules were treated with RF ablation, and 36 patients with 46 nodules were treated with PMC. Therapeutic effect, residual foci of untreated disease, and complications of RF ablation and PMC were prospectively evaluated with statistical analyses.

RESULTS

The number of treatment sessions per nodule was significantly lower in the RF ablation group than in the PMC group (1.1 vs 2.4; P <.001). Complete therapeutic effect was achieved in 46 (96%) of 48 nodules treated with RF ablation and in 41 (89%) of 46 nodules treated with PMC (P =.26). Major complications occurred in one patient treated with RF ablation and in four patients treated with PMC (P =.36). During follow-up (range, 6-27 months), residual foci of untreated disease were seen in four of 48 nodules treated with RF ablation and in eight of 46 nodules treated with PMC. No significant difference in rates of residual foci of untreated disease was noted (P =.20, log-rank test).

CONCLUSION

RF ablation and PMC thus far have had equivalent therapeutic effects, complication rates, and rates of residual foci of untreated disease. However, RF tumor ablation can be achieved with fewer sessions.

摘要

目的

评估射频(RF)消融和经皮微波凝固(PMC)治疗肝细胞癌(HCC)的有效性。

材料与方法

72例患有94个HCC结节的患者被随机分为RF消融组和PMC组。36例患有48个结节的患者接受RF消融治疗,36例患有46个结节的患者接受PMC治疗。对RF消融和PMC的治疗效果、未治疗疾病的残留病灶及并发症进行前瞻性评估并进行统计分析。

结果

RF消融组每个结节的治疗次数显著低于PMC组(1.1比2.4;P<.001)。接受RF消融治疗的48个结节中有46个(96%)达到完全治疗效果,接受PMC治疗的46个结节中有41个(89%)达到完全治疗效果(P=.26)。1例接受RF消融治疗的患者和4例接受PMC治疗的患者发生了严重并发症(P=.36)。在随访期间(范围为6 - 27个月),接受RF消融治疗的48个结节中有4个出现未治疗疾病的残留病灶,接受PMC治疗的46个结节中有8个出现未治疗疾病的残留病灶。未治疗疾病残留病灶的发生率无显著差异(P=.20,对数秩检验)。

结论

迄今为止,RF消融和PMC在治疗效果、并发症发生率及未治疗疾病残留病灶发生率方面相当。然而,RF肿瘤消融所需的治疗次数较少。

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