Ginsburg Michael, Zivin Sean P, Wroblewski Kristen, Doshi Taral, Vasnani Raj J, Van Ha Thuong G
Department of Radiology, Division of Interventional Radiology, University of Chicago Medical Center, Chicago, Illinois..
Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital & Health Sciences System, Chicago, Illinois.
J Vasc Interv Radiol. 2015 Mar;26(3):330-41. doi: 10.1016/j.jvir.2014.10.047. Epub 2014 Dec 18.
To compare retrospectively the outcomes and complications of transcatheter arterial chemoembolization with drug-eluting embolic agents combined with radiofrequency (RF) ablation or microwave (MW) ablation in treatment of hepatocellular carcinoma (HCC).
From 2003-2011, 89 patients with HCC received a combination therapy-transcatheter arterial chemoembolization plus RF ablation in 38 patients and transcatheter arterial chemoembolization plus MW ablation in 51 patients. Local tumor response, tumor progression-free survival (PFS), overall PFS, overall survival (OS), and complications were compared. Overall PFS and OS were compared between the two treatment groups in multivariate analysis controlling for Child-Pugh class, Barcelona Clinic Liver Classification stage, and index tumor size.
Complete local tumor response was achieved in 37 (80.4%) of the tumors treated with transcatheter arterial chemoembolization plus RF ablation and 49 (76.6%) of the tumors treated with transcatheter arterial chemoembolization plus MW ablation (P = .67). The median tumor PFS and overall PFS were 20.8 months and 9.3 months (P = .72) for transarterial chemoembolization plus RF ablation and 21.8 months and 9.2 months for transarterial chemoembolization plus MW ablation (P = .32). The median OS of the transcatheter arterial chemoembolization plus RF ablation group was 23.3 months, and the median OS of the transcatheter arterial chemoembolization plus MW ablation group was 42.6 months, with no significant difference in the survival experience between the two groups (log-rank test, P = .10). In the multivariate analysis, Barcelona Clinic Liver Classification stage was the only factor associated with overall PFS and OS. One patient in the transcatheter arterial chemoembolization plus RF ablation cohort (3%) and two patients in the transcatheter arterial chemoembolization plus MW ablation cohort (4%) required prolonged hospitalization (< 48 h) for pain management after the procedure (P = 1.00).
Based on similar safety and efficacy outcomes, both combination therapies, transcatheter arterial chemoembolization plus RF ablation and transcatheter arterial chemoembolization plus MW ablation, are effective treatments for HCC.
回顾性比较经动脉化疗栓塞联合药物洗脱栓塞剂与射频（RF）消融或微波（MW）消融治疗肝细胞癌（HCC）的疗效和并发症。
2003年至2011年，89例HCC患者接受联合治疗，其中38例接受经动脉化疗栓塞联合RF消融，51例接受经动脉化疗栓塞联合MW消融。比较局部肿瘤反应、无肿瘤进展生存期（PFS）、总PFS、总生存期（OS）及并发症。在多因素分析中，对Child-Pugh分级、巴塞罗那临床肝癌分期和肿瘤大小指数进行校正后，比较两个治疗组的总PFS和OS。
经动脉化疗栓塞联合RF消融治疗的肿瘤中，37例（80.4%）实现了完全局部肿瘤反应；经动脉化疗栓塞联合MW消融治疗的肿瘤中，49例（76.6%）实现了完全局部肿瘤反应（P = 0.67）。经动脉化疗栓塞联合RF消融的中位肿瘤PFS和总PFS分别为20.8个月和9.3个月（P = 0.72），经动脉化疗栓塞联合MW消融的中位肿瘤PFS和总PFS分别为21.8个月和9.2个月（P = 0.32）。经动脉化疗栓塞联合RF消融组的中位OS为23.3个月，经动脉化疗栓塞联合MW消融组的中位OS为42.6个月，两组生存经验无显著差异（对数秩检验，P = 0.10）。在多因素分析中，巴塞罗那临床肝癌分期是与总PFS和OS相关的唯一因素。经动脉化疗栓塞联合RF消融组有1例患者（3%）、经动脉化疗栓塞联合MW消融组有2例患者（4%）术后因疼痛管理需要延长住院时间（< 48小时）（P = 1.00）。
基于相似的安全性和疗效结果，经动脉化疗栓塞联合RF消融和经动脉化疗栓塞联合MW消融这两种联合治疗方法都是治疗HCC的有效方法。
