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射频消融联合低频超声辐射微泡治疗恶性肝肿瘤。

Treatment of malignant liver tumors by radiofrequency ablation combined with low-frequency ultrasound radiation with microbubbles.

机构信息

Department of General Surgery, Chinese People's Armed Police Force 8710 Hospital, Putian, Fujian Province, People's Republic of China.

出版信息

PLoS One. 2013;8(1):e53351. doi: 10.1371/journal.pone.0053351. Epub 2013 Jan 10.

Abstract

OBJECTIVE

To explore the therapeutic efficacy and safety of malignant liver tumor treatment by radiofrequency ablation (RA) combined with low frequency ultrasound radiation with microbubbles (LFURM).

METHODS

Retrospective analysis of 25 patients with malignant hepatic tumors treated by RA/LFURM in the Department of Hepatobiliary Surgery of Kunming General Hospital affiliated to Chengdu Military District, PLA from January 2010 to June 2011. Ultrasound guided RA was performed, which was followed one week later by LFURM. Basal contrast ultrasound, liver function tests, and serum alpha fetoprotein (AFP) were obtained, and repeated 3 and 6 months after treatment. T-test and chi-square were used to compare parametric and non-parametric variables respectively.

RESULTS

In 17 cases, gross tumor volume was significantly reduced 6 months after treatment while mean tumor showed a reduction of 50% compared to pre-treatment values. In 7 cases gross tumor volumes reduction was partial, but surrounding tumor tissue showed blood flow signals. One patient had no reduction in gross tumor volume. Levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), alpha fetoprotein (AFP) decreased significantly 6 months after treatment (all p<0.05). No tumor recurrence was seen during the 6 month follow-up. Quality of life scores (QOL) were good in 21 patients (84%), improved in 2 patients (8%), unchanged in 1 patient (4%) and got worst in 1 patient (4%). Karnofsky scores (KPS) improved in 19 patients (76%), remained unchanged in 5 patients (2%) and got worst in 1 patient (4%). Both QOL and KPS changes were statistically significant (P<0.05).

CONCLUSION

RA/LFURM treatment of liver tumors is efficient and safe, and can reduce the gross tumor volumes and protect liver function.

摘要

目的

探讨射频消融(RA)联合低频超声辐射微泡(LFURM)治疗恶性肝肿瘤的疗效和安全性。

方法

回顾性分析 2010 年 1 月至 2011 年 6 月成都军区昆明总医院肝胆外科 25 例接受 RA/LFURM 治疗的恶性肝肿瘤患者。超声引导下进行 RA,一周后进行 LFURM。获得基础对比超声、肝功能检查和血清甲胎蛋白(AFP),并在治疗后 3 个月和 6 个月重复检查。分别采用 t 检验和卡方检验比较参数和非参数变量。

结果

17 例患者治疗 6 个月后肿瘤体积明显缩小,平均肿瘤体积较治疗前缩小 50%。7 例患者肿瘤体积部分缩小,但周围肿瘤组织有血流信号。1 例患者肿瘤体积无缩小。治疗后 6 个月,血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、甲胎蛋白(AFP)水平显著下降(均 P<0.05)。6 个月随访未见肿瘤复发。21 例患者(84%)生活质量评分(QOL)良好,2 例(8%)改善,1 例(4%)不变,1 例(4%)恶化。19 例患者(76%)卡氏功能状态评分(KPS)提高,5 例(2%)不变,1 例(4%)恶化。QOL 和 KPS 变化均有统计学意义(P<0.05)。

结论

RA/LFURM 治疗肝肿瘤疗效确切,安全,能缩小肿瘤体积,保护肝功能。

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