1 Department of Hepatobiliary Surgery; 2 Department of Medical Imaging, the Second Affiliated Hospital of Southeast University, Nanjing 210003, China.
Chin J Cancer Res. 2014 Feb;26(1):112-8. doi: 10.3978/j.issn.1000-9604.2014.02.09.
To compare radiofrequency ablation (RFA) or microwave ablation (MWA) and transcatheter arterial chemoembolization (TACE) with RFA or MWA monotherapy in hepatocellular carcinoma (HCC).
A prospective, randomized, controlled trial was conducted on 94 patients with HCC ≤7 cm at a single tertiary referral center from June 2008 to June 2010 at the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Southeast University. The patients were randomly assigned into the TACE-RFA or TACE-MWA (combined treatment group) and the RFA-alone or MWA-alone groups (control group). The primary end point was overall survival. The secondary end point was recurrence-free survival, and the tertiary end point was adverse effects.
Until the time of censor, 17 patients in the TACE-RFA or TACE-MWA group had died. The median follow-up time of the patients who were still alive for the TACE-RFA or TACE-MWA group was 47.5±11.3 months (range, 29 to 62 months). The 1-, 3- and 5-year overall survival for the TACE-RFA or TACE-MWA group was 93.6%, 68.1% and 61.7%, respectively. Twenty-five patients in the RFA or MWA group had died. The median follow-up time of the patients who were still alive for the RFA or MWA group was 47.0±12.9 months (range, 28 to 62 months). The 1-, 3- and 5-year overall survival for the RFA or MWA group was 85.1%, 59.6% and 44.7%, respectively. The patients in the TACE-RFA or TACE-MWA group had better overall survival than the RFA or MWA group [hazard ratio (HR), 0.526; 95% confidence interval (95% CI), 0.334-0.823; P=0.002], and showed better recurrence-free survival than the RFA or MWA group (HR, 0.582; 95% CI, 0.368-0.895; P=0.008).
RFA or MWA combined with TACE in the treatment of HCC ≤7 cm was superior to RFA or MWA alone in improving survival by reducing arterial and portal blood flow due to TACE with iodized oil before RFA.
比较射频消融（RFA）或微波消融（MWA）联合经导管肝动脉化疗栓塞（TACE）与 RFA 或 MWA 单独治疗肝细胞癌（HCC）的疗效。
2008 年 6 月至 2010 年 6 月，在东南大学第二附属医院肝胆外科，进行了一项前瞻性、随机、对照临床试验，纳入了 94 例最大直径≤7cm 的 HCC 患者。患者被随机分配到 TACE-RFA 或 TACE-MWA（联合治疗组）和 RFA 或 MWA 单独治疗组（对照组）。主要终点是总生存。次要终点是无复发生存，三级终点是不良反应。
截至删失时间，TACE-RFA 或 TACE-MWA 组有 17 例患者死亡。TACE-RFA 或 TACE-MWA 组仍存活患者的中位随访时间为 47.5±11.3 个月（范围 29 至 62 个月）。TACE-RFA 或 TACE-MWA 组的 1、3 和 5 年总生存率分别为 93.6%、68.1%和 61.7%。RFA 或 MWA 组有 25 例患者死亡。RFA 或 MWA 组仍存活患者的中位随访时间为 47.0±12.9 个月（范围 28 至 62 个月）。RFA 或 MWA 组的 1、3 和 5 年总生存率分别为 85.1%、59.6%和 44.7%。TACE-RFA 或 TACE-MWA 组的总生存情况优于 RFA 或 MWA 组[风险比（HR），0.526；95%置信区间（95%CI），0.334-0.823；P=0.002]，且无复发生存情况也优于 RFA 或 MWA 组（HR，0.582；95%CI，0.368-0.895；P=0.008）。
对于最大直径≤7cm 的 HCC，RFA 或 MWA 联合 TACE 治疗可通过 TACE 碘油栓塞降低动脉和门静脉血流，从而提高生存率，优于 RFA 或 MWA 单独治疗。
