射频消融治疗肝细胞癌：低与最大射频功率的应用。

Radiofrequency ablation for hepatocellular carcinoma: use of low vs maximal radiofrequency power.

机构信息

Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.

出版信息

Br J Radiol. 2012 Jun;85(1014):e102-9. doi: 10.1259/bjr/85505073. Epub 2011 Mar 22.

DOI:10.1259/bjr/85505073

PMID:21427178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3474107/

Abstract

OBJECTIVES

To investigate whether radiofrequency (RF) ablation with low power (LP) or maximal power (MP) for hepatocellular carcinoma (HCC) can achieve optimal ablation and fewer adverse effects.

METHODS

RF ablation was performed with MP in 101 patients (129 tumours) and with LP in 46 patients (61 tumours). MP RF ablation used power of >120 W. RF power below this was designated as LP. Clinical outcomes were also analysed in subgroups of high-risk tumours near the bile duct and blood vessels.

RESULTS

Primary effectiveness was achieved in 91.8% in the LP group and 89.9% in the MP group (p = 0.795). 1 and 2-year local tumour progression rates were 28% and 30%, respectively, in the LP group, and 24% and 29%, respectively, in the MP group (p = 0.70). 1 and 2-year survival rates were 98% and 98%, respectively, in the LP group, and 93% and 90%, respectively, in the MP group (p = 0.216). The MP group had more adverse effects, with post-RF ablation syndrome, asymptomatic pleural effusion and ascites, than the LP group (20% vs 39% in the MP group; p = 0.027); however, there was no significant difference in major complication rates (6% in the MP and LP groups; p = 0.497). Among the patients with high-risk tumours, RF ablation using MP vs LP was comparable in primary effectiveness (91.7% vs 95.2%; p = 0.618), local tumour progression (42.9% vs 29.2%; p = 0.304) and overall complications (5% vs 8%; p=0.618).

CONCLUSION

RF ablation with LP and MP are comparable in clinical outcomes but considerably fewer adverse effects were encountered in the LP group.

摘要

目的

研究肝癌（HCC）低功率（LP）或最大功率（MP）射频消融（RF）能否达到最佳消融效果和减少不良影响。

方法

101 例（129 个肿瘤）患者采用 MP 行 RF 消融，46 例（61 个肿瘤）患者采用 LP 行 RF 消融。MP RF 消融使用功率>120 W，低于此功率的设定为 LP。还对靠近胆管和血管的高危肿瘤亚组进行了临床结局分析。

结果

LP 组的主要有效性为 91.8%，MP 组为 89.9%（p=0.795）。LP 组的 1 年和 2 年局部肿瘤进展率分别为 28%和 30%，MP 组分别为 24%和 29%（p=0.70）。LP 组的 1 年和 2 年生存率分别为 98%和 98%，MP 组分别为 93%和 90%（p=0.216）。MP 组的不良事件发生率高于 LP 组，包括射频消融后综合征、无症状性胸腔积液和腹水（20%比 39%；p=0.027），但主要并发症发生率无差异（6%比 6%；p=0.497）。高危肿瘤患者中，MP 与 LP 相比，主要有效性（91.7%比 95.2%；p=0.618）、局部肿瘤进展（42.9%比 29.2%；p=0.304）和总体并发症（5%比 8%；p=0.618）无显著差异。