射频消融联合载药微球经动脉化疗栓塞治疗单个大肝细胞癌
Radiofrequency ablation plus drug-eluting beads transcatheter arterial chemoembolization for the treatment of single large hepatocellular carcinoma.
作者信息
Iezzi Roberto, Pompili Maurizio, La Torre Michele Fabio, Campanale Maria Chiara, Montagna Martina, Saviano Antonio, Cesario Valentina, Siciliano Massimo, Annicchiarico Eleonora, Agnes Salvatore, Giuliante Felice, Grieco Antonio, Rapaccini Gian Lodovico, De Gaetano Anna Maria, Gasbarrini Antonio, Bonomo Lorenzo
机构信息
Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital - Catholic University, Rome, Italy; Division of Medical Oncology, "A. Gemelli" Hospital - Catholic University, Rome, Italy.
Department of Internal Medicine, "A. Gemelli" Hospital - Catholic University, Rome, Italy; Division of Medical Oncology, "A. Gemelli" Hospital - Catholic University, Rome, Italy.
出版信息
Dig Liver Dis. 2015 Mar;47(3):242-8. doi: 10.1016/j.dld.2014.12.007. Epub 2014 Dec 13.
BACKGROUND
Our aim was to evaluate the effectiveness of the single-step combined therapy with radiofrequency ablation and drug-eluting beads transarterial chemoembolization in single hepatocellular carcinoma (HCC) larger than 3cm. Secondary aim was to compare the results with those obtained in a matched population treated with drug-eluting beads transarterial chemoembolization alone.
METHODS
40 consecutive cirrhotic patients with single HCC were prospectively enrolled and treated. Twenty-three patients had tumours between 3 and 5cm (Group A), and 17 larger than 5cm (Group B). Twenty cirrhotic patients with single HCC treated only with chemoembolization formed the control group.
RESULTS
Complete response at 1 month was achieved in 32/40 tumours (80%). During follow-up, complete response was maintained in 25 patients (25/40, 62.5%), and this rate was higher in Group A (69.6% vs 53%, p=0.008). The group treated with combined therapy showed a significantly lower 2-year recurrence (48.1% vs 78.2%, p<0.001) and significantly higher survival (91.1% vs 60.6%, p=0.004) than the group treated with chemoembolization alone.
CONCLUSIONS
Balloon-occluded-radiofrequency ablation plus drug-eluting beads transarterial chemoembolization is an effective treatment of HCC larger than 3cm not amenable to surgical resection, providing better results than transarterial chemoembolization alone. The best results are achieved in tumours up to 5cm.
背景
我们的目的是评估射频消融联合载药微球经动脉化疗栓塞的单步联合疗法对直径大于3cm的单发肝细胞癌（HCC）的有效性。次要目的是将结果与仅接受载药微球经动脉化疗栓塞治疗的匹配人群的结果进行比较。
方法
前瞻性纳入并治疗40例连续性肝硬化单发HCC患者。23例患者的肿瘤直径在3至5cm之间（A组），17例患者的肿瘤直径大于5cm（B组）。20例仅接受化疗栓塞治疗的肝硬化单发HCC患者组成对照组。
结果
40个肿瘤中有32个（80%）在1个月时达到完全缓解。在随访期间，25例患者（25/40，62.5%）维持完全缓解，A组的这一比例更高（69.6%对53%，p = 0.008）。联合治疗组的2年复发率显著低于单纯化疗栓塞组（48.1%对78.2%，p < 0.001），生存率显著高于单纯化疗栓塞组（91.1%对60.6%，p = 0.004）。
结论
球囊闭塞射频消融联合载药微球经动脉化疗栓塞是治疗直径大于3cm、不宜手术切除的HCC的有效方法，其效果优于单纯经动脉化疗栓塞。直径达5cm的肿瘤治疗效果最佳。
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