Potretzke Theodora A, Ziemlewicz Timothy J, Hinshaw J Louis, Lubner Meghan G, Wells Shane A, Brace Christopher L, Agarwal Parul, Lee Fred T
Departments of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/366, Madison, WI 53792-3252.
Departments of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/366, Madison, WI 53792-3252..
J Vasc Interv Radiol. 2016 May;27(5):631-8. doi: 10.1016/j.jvir.2016.01.136. Epub 2016 Mar 24.
To compare efficacy and major complication rates of radiofrequency (RF) and microwave (MW) ablation for treatment of hepatocellular carcinoma (HCC).
This retrospective single-center study included 69 tumors in 55 patients treated by RF ablation and 136 tumors in 99 patients treated by MW ablation between 2001 and 2013. RF and MW ablation devices included straight 17-gauge applicators. Overall survival and rates of local tumor progression (LTP) were evaluated using Kaplan-Meier techniques with Cox proportional hazard ratio (HR) models and competing risk regression of LTP.
RF and MW cohorts were similar in age (P = .22), Model for End-Stage Liver Disease score (P = .24), and tumor size (mean 2.4 cm [range, 0.6-4.5 cm] and 2.2 cm [0.5-4.2 cm], P = .09). Median length of follow-up was 31 months for RF and 24 months for MW. Rate of LTP was 17.7% with RF and 8.8% with MW. Corresponding HR from Cox and competing risk models was 2.17 (95% confidence interval [CI], 1.04-4.50; P = 0.04) and 2.01 (95% CI, 0.95-4.26; P = .07), respectively. There was improved survival for patients treated with MW ablation, although this was not statistically significant (Cox HR, 1.59 [95% CI, 0.91-2.77; P = .103]). There were few major (≥ grade C) complications (2 for RF, 1 for MW; P = .28).
Treating HCC percutaneously with RF or MW ablation was associated with high primary efficacy and durable response, with lower rates of LTP after MW ablation.
比较射频（RF）和微波（MW）消融治疗肝细胞癌（HCC）的疗效和主要并发症发生率。
这项回顾性单中心研究纳入了2001年至2013年间接受RF消融治疗的55例患者中的69个肿瘤以及接受MW消融治疗的99例患者中的136个肿瘤。RF和MW消融设备包括直的17号穿刺针。采用Kaplan-Meier技术、Cox比例风险比（HR）模型以及LTP的竞争风险回归评估总生存率和局部肿瘤进展（LTP）率。
RF组和MW组在年龄（P = 0.22）、终末期肝病模型评分（P = 0.24）和肿瘤大小（平均2.4 cm [范围，0.6 - 4.5 cm] 和2.2 cm [0.5 - 4.2 cm]，P = 0.09）方面相似。RF组的中位随访时间为31个月，MW组为24个月。RF组的LTP率为17.7%，MW组为8.8%。Cox模型和竞争风险模型对应的HR分别为2.17（95%置信区间[CI]，1.04 - 4.50；P = 0.04）和2.01（95% CI，0.95 - 4.26；P = 0.07）。接受MW消融治疗的患者生存率有所提高，尽管这在统计学上无显著意义（Cox HR，1.59 [95% CI，0.91 - 2.77；P = 0.103]）。严重（≥C级）并发症较少（RF组2例，MW组1例；P = 0.28）。
经皮用RF或MW消融治疗HCC具有较高的初始疗效和持久反应，MW消融后的LTP率较低。
