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图像引导下多极射频消融治疗肝肿瘤:初步临床结果

Image-guided multipolar radiofrequency ablation of liver tumours: initial clinical results.

作者信息

Terraz Sylvain, Constantin Christophe, Majno Pietro Edoardo, Spahr Laurent, Mentha Gilles, Becker Christoph D

机构信息

Department of Radiology, Geneva University Hospital, rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland.

出版信息

Eur Radiol. 2007 Sep;17(9):2253-61. doi: 10.1007/s00330-007-0626-x. Epub 2007 Mar 21.

Abstract

The local effectiveness and clinical usefulness of multipolar radiofrequency (RF) ablation of liver tumours was evaluated. Sixty-eight image-guided RF sessions were performed using a multipolar device with bipolar electrodes in 53 patients. There were 45 hepatocellular carcinomas (HCC) and 42 metastases with a diameter < or =3 cm (n = 55), 3.1-5 cm (n = 29) and >5 cm (n = 3); 26 nodules were within 5 mm from large vessels. Local effectiveness and complications were evaluated after RF procedures. Mean follow-up was 17 +/- 10 months. Recurrence and survival rates were analysed by the Kaplan-Meier method. The primary and secondary technical effectiveness rate was 82% and 95%, respectively. The major and minor complication rate was 2.9%, respectively. The local tumour progression at 1- and 2-years was 5% and 9% for HCC nodules and 17% and 31% for metastases, respectively; four of 26 nodules (15%) close to vessels showed local progression. The survival at 1 year and 2 years was 97% and 90% for HCC and 84% and 68% for metastases, respectively. Multipolar RF technique creates ablation zones of adequate size and tailored shape and is effective to treat most liver tumours, including those close to major hepatic vessels.

摘要

评估了多极射频(RF)消融肝肿瘤的局部有效性和临床实用性。使用带有双极电极的多极设备对53例患者进行了68次图像引导下的RF治疗。有45例肝细胞癌(HCC)和42处转移灶,直径≤3 cm(n = 55)、3.1 - 5 cm(n = 29)和>5 cm(n = 3);26个结节距离大血管不到5 mm。在RF治疗后评估局部有效性和并发症。平均随访时间为17±10个月。采用Kaplan-Meier法分析复发率和生存率。原发性和继发性技术有效率分别为82%和95%。主要和次要并发症发生率分别为2.9%。HCC结节1年和2年的局部肿瘤进展率分别为5%和9%,转移灶分别为17%和31%;26个靠近血管的结节中有4个(15%)出现局部进展。HCC 1年和2年生存率分别为97%和90%,转移灶分别为84%和68%。多极RF技术可形成大小合适且形状适宜的消融区,对治疗大多数肝肿瘤有效,包括那些靠近主要肝血管的肿瘤。

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