Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China.
Eur J Radiol. 2012 Oct;81(10):2717-25. doi: 10.1016/j.ejrad.2011.10.023. Epub 2012 Jan 14.
To assess the time to disease progression (TTP), long-term survival benefit and safety of patients with unresectable hepatocellular carcinoma (HCC) treated with computed tomography (CT)-guided radiofrequency ablation (RFA) with transarterial chemoembolization chemoembolization (TACE).
This study was approved by the institutional review board. We reviewed the records of patients with intermediate and advanced HCC treated with CT-guided RFA with TACE between January 2000 and December 2009. Median TTP, overall survival (OS) and hepatic function were analyzed with the Kaplan-Meier method and log-rank tests.
One hundred and twenty-two patients (112 men and 10 women, mean age 53 years, range 18-86 years) were included in the study. The median follow-up time was 42 months (range 6-89 months), TTP was 6.8 months, the median OS was 31 months, and the 1-, 3-, and 5-year OS were 88.5%, 41.0%, and 10.7%. The results of the univariate analysis revealed that intrahepatic lesion, AJCC stage, and Child-Pugh stage were predictors of OS (P<0.01). In the multivariate analysis, the AJCC stage system showed a statistically significant difference for prognosis. Procedure-related death was 0.21% (1/470) within 1 month, and a statistical difference was found between the TACE and RFA of liver decompensation and Child-Pugh stage (P<0.05).
The survival probabilities of OS increased with CT-guided RFA with TACE, as observed in randomized studies from Europe and Asia. The longest TTP was observed for the intermediate stage HCC. The procedures were well tolerated with acceptable minor and major complications in unresectable HCC patients.
评估经 CT 引导射频消融（RFA）联合经动脉化疗栓塞（TACE）治疗不可切除肝细胞癌（HCC）患者的疾病进展时间（TTP）、长期生存获益和安全性。
本研究经机构审查委员会批准。我们回顾了 2000 年 1 月至 2009 年 12 月期间接受 CT 引导 RFA 联合 TACE 治疗的中晚期 HCC 患者的病历。采用 Kaplan-Meier 法和对数秩检验分析中位 TTP、总生存期（OS）和肝功能。
本研究共纳入 122 例患者（112 例男性，10 例女性；平均年龄 53 岁，范围 18-86 岁）。中位随访时间为 42 个月（范围 6-89 个月），TTP 为 6.8 个月，中位 OS 为 31 个月，1、3 和 5 年 OS 分别为 88.5%、41.0%和 10.7%。单因素分析结果显示，肝内病变、AJCC 分期和 Child-Pugh 分级是 OS 的预测因素（P<0.01）。多因素分析显示，AJCC 分期系统对预后有统计学意义。1 个月内与治疗相关的死亡率为 0.21%（1/470），TACE 和 RFA 导致肝功能失代偿和 Child-Pugh 分级的差异有统计学意义（P<0.05）。
与欧洲和亚洲的随机研究结果一致，经 CT 引导 RFA 联合 TACE 治疗可提高 OS 的生存率。对于中期 HCC，TTP 最长。在不可切除 HCC 患者中，该治疗方案耐受性良好，轻微和严重并发症发生率可接受。
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