Ultrasound Department, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
Hepatol Res. 2009 Mar;39(3):231-40. doi: 10.1111/j.1872-034X.2008.00451.x. Epub 2008 Nov 5.
To assess the efficacy and safety of radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) in recurrent hepatocellular carcinoma (HCC) after hepatectomy and to compare its outcome with a single modality.
We retrospectively studied 103 patients with recurrent HCCs after hepatectomy who were excluded from repeat hepatectomy. Of them, 81 patients were male and 22 were female (mean age 55.8 +/- 10.7 years; range, 30-80 years). According to treatment modality, these patients were divided into three groups: RFA was used as the sole first-line anticancer treatment in 37 patients (RFA group); TACE was used as the sole first-line anticancer treatment in 35 patients (TACE group). RFA followed by TACE was performed in 31 patients (combination group). There was no significant difference in clinical material between the three groups. Indices including treatment success rate, intrahepatic recurrence rate and survival were obtained for analysis and comparison.
The treatment success rate of the combination group was significantly higher than that of the TACE group (93.5 vs. 68.6%, P = 0.011). The intrahepatic recurrence rate of the combination group was significantly lower than that of the TACE group (20.7 vs 57.1%, P = 0.002) and the RFA group (20.7 vs 43.2%, P = 0.036). The overall 1-, 3- and 5-year survival rates were 73.9, 51.1 and 28.0% respectively in the RFA group; 65.8, 38.9 and 19.5% respectively in the TACE group; and 88.5, 64.6 and 44.3% respectively in the combination group. There was a significant difference in survival between the combination group and the TACE group (P = 0.028).
RFA combined with TACE was more effective in treating recurrent HCC after hepatectomy compared to single RFA or TACE treatment. This combination therapy can thus be a valuable choice of treatment for recurrent HCC.
评估射频消融（RFA）联合肝动脉化疗栓塞（TACE）治疗肝癌切除术后复发的疗效和安全性，并与单一治疗方法进行比较。
我们回顾性研究了 103 例因无法再次行肝切除术而被排除在外的肝癌切除术后复发患者。其中男性 81 例，女性 22 例（平均年龄 55.8 +/- 10.7 岁；范围，30-80 岁）。根据治疗方式，将这些患者分为三组：RFA 作为唯一一线抗癌治疗的 37 例（RFA 组）；TACE 作为唯一一线抗癌治疗的 35 例（TACE 组）。RFA 联合 TACE 治疗的 31 例患者（联合组）。三组间临床资料无明显差异。获取并分析比较各组治疗成功率、肝内复发率和生存率等指标。
联合组的治疗成功率明显高于 TACE 组（93.5%比 68.6%，P = 0.011）。联合组的肝内复发率明显低于 TACE 组（20.7%比 57.1%，P = 0.002）和 RFA 组（20.7%比 43.2%，P = 0.036）。RFA 组的 1、3、5 年总生存率分别为 73.9%、51.1%和 28.0%；TACE 组分别为 65.8%、38.9%和 19.5%；联合组分别为 88.5%、64.6%和 44.3%。联合组与 TACE 组的生存率有显著差异（P = 0.028）。
与单独 RFA 或 TACE 治疗相比，RFA 联合 TACE 治疗肝癌切除术后复发更有效。因此，这种联合治疗可能是肝癌复发的一种有价值的治疗选择。
