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射频消融联合全身化疗治疗鼻咽癌肝转移可提高治疗反应和生存结局。

Radiofrequency ablation combined with systemic chemotherapy in nasopharyngeal carcinoma liver metastases improves response to treatment and survival outcomes.

机构信息

Department of Medical Oncology, Zhejiang Cancer Hospital, China.

出版信息

J Surg Oncol. 2012 Sep 1;106(3):322-6. doi: 10.1002/jso.23034. Epub 2012 Jan 23.

Abstract

BACKGROUND

Systemic chemotherapy is the major treatment modality for nasopharyngeal carcinoma (NPC) liver metastases. We investigated the effectiveness of radiofrequency ablation (RFA) treatment, which has not been well explored in this disease.

METHODS

One-hundred and thirty-four cases of NPC with liver metastases treated with chemotherapy, chemotherapy with RFA, or RFA alone were retrospectively analyzed. Patient survival was evaluated by the log-rank test. Survival was analyses using the Kaplan-Meier method. Cox multivariate analyses of clinicopathological features and different treatment approaches were conducted.

RESULTS

Local response rates were 58% in the RFA group, 78% in the chemotherapy group and 93% in the chemotherapy with RFA group (P < 0.001). Increased progression-free survival (PFS) and overall survival (OS) were observed in the chemotherapy with RFA group (P < 0.001). Cox multivariate analysis indicated that the number of liver metastases (1 vs. >1), the dimension of the largest liver metastases (≤3 cm vs. >3 cm), evaluation of treatment (response vs. no response) and disease-free survival (≤12 months vs. >12 months) were independent prognostic factors.

CONCLUSIONS

RFA combined with chemotherapy is a promising treatment for NPC metastatic liver disease with improved local response, PFS, and OS compared to current chemotherapy protocols.

摘要

背景

全身化疗是鼻咽癌(NPC)肝转移的主要治疗方式。我们研究了射频消融(RFA)治疗的效果,该方法在这种疾病中尚未得到充分探索。

方法

回顾性分析了 134 例接受化疗、化疗联合 RFA 或单纯 RFA 治疗的 NPC 肝转移患者。采用对数秩检验评估患者的生存情况。采用 Kaplan-Meier 方法进行生存分析。对临床病理特征和不同治疗方法进行 Cox 多因素分析。

结果

RFA 组的局部反应率为 58%,化疗组为 78%,化疗联合 RFA 组为 93%(P<0.001)。化疗联合 RFA 组的无进展生存期(PFS)和总生存期(OS)均有所延长(P<0.001)。Cox 多因素分析表明,肝转移数量(1 个 vs. >1 个)、最大肝转移灶直径(≤3cm vs. >3cm)、治疗评估(有反应 vs. 无反应)和无疾病生存期(≤12 个月 vs. >12 个月)是独立的预后因素。

结论

与目前的化疗方案相比,RFA 联合化疗治疗 NPC 转移性肝疾病具有更好的局部反应率、PFS 和 OS,是一种很有前途的治疗方法。

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