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射频消融联合经动脉化疗栓塞治疗肝细胞癌的临床疗效:单中心经验

[Clinical outcomes of radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma: a single-center experience].

作者信息

Lin Jie-jun, Wu Wei, Jiang Xiao-fen, Jin Xiao-jun, Lu Li-jie, Bao Luo-wen

机构信息

Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2013 Feb;35(2):144-7. doi: 10.3760/cma.j.issn.0253-3766.2013.02.016.

Abstract

OBJECTIVE

To compare the effect of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) with radiofrequency ablation alone for the treatment of 3 - 5 cm hepatocellular carcinoma (HCC).

METHODS

From January 2006 to March 2010, sixty-two HCC patients were randomly treated with RFA combined with TACE (n = 32) or RFA alone (n = 30). This group included the patients who had Child-Pugh class A or B with three or fewer tumors, in which just one tumor size was 3 - 5 cm in diameter, and no evidence of extrahepatic tumor metastasis or macrovascular invasion. The follow up ranged from 9 to 39 months. Survival probabilities were estimated with the Kaplan-Meier method, and differences between survival curves were evaluated with the Log rank test.

RESULTS

At the end of the study, the 1-, 2- and 3-year overall survival rates in the combined treatment group were 90.6%, 72%, and 53.1%, respectively, and in the radiofrequency ablation alone group were 83.3%, 56.75%, and 23.3%, respectively. The differences between the survival curves of the two groups were not statistically significant (P = 0.176). The 1-, 2-, and 3-year progress-free survival rates in the combined treatment group were 75.0%, 50.0%, and 34.3%, respectively, and in the radiofrequency ablation alone group were 63.3%, 33.3%, and 16.7%, respectively. The differences between the two groups were statistically significant (P = 0.027). The 1-, 2-, and 3-year local tumor progression rates in the combined treatment group were 12.5%, 18.75%, and 18.75% vs. 16.7%, 30%, and 36.6% in the radiofrequency ablation alone group, with a significant difference between the two groups (P = 0.047).

CONCLUSION

Radiofrequency ablation plus TACE is better than radiofrequency ablation alone for the treatment of 3 - 5 cm hepatocellular carcinoma.

摘要

目的

比较射频消融(RFA)联合经动脉化疗栓塞术(TACE)与单纯射频消融治疗3 - 5厘米肝细胞癌(HCC)的效果。

方法

2006年1月至2010年3月,62例HCC患者被随机分为RFA联合TACE组(n = 32)或单纯RFA组(n = 30)。该组患者包括Child-Pugh A级或B级、肿瘤数量为3个或更少、其中仅一个肿瘤直径为3 - 5厘米、且无肝外肿瘤转移或大血管侵犯证据的患者。随访时间为9至39个月。采用Kaplan-Meier法估计生存概率,并用Log rank检验评估生存曲线之间的差异。

结果

研究结束时,联合治疗组的1年、2年和3年总生存率分别为90.6%、72%和53.1%,单纯射频消融组分别为83.3%、56.75%和23.3%。两组生存曲线之间的差异无统计学意义(P = 0.176)。联合治疗组的1年、2年和3年无进展生存率分别为75.0%、50.0%和34.3%,单纯射频消融组分别为63.3%、33.3%和16.7%。两组之间的差异有统计学意义(P = 0.027)。联合治疗组的1年、2年和3年局部肿瘤进展率分别为12.5%、18.75%和18.75%,而单纯射频消融组分别为16.7%、30%和36.6%,两组之间有显著差异(P = 0.047)。

结论

对于3 - 5厘米肝细胞癌的治疗,射频消融联合TACE优于单纯射频消融。

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