射频消融单独及联合经皮乙醇注射治疗肝细胞癌的比较。
Comparison of radiofrequency ablation alone & in combination with percutaneous ethanol injection for management of hepatocellular carcinoma.
机构信息
Department of Radiodiagnosis & Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
出版信息
Indian J Med Res. 2017 Nov;146(Suppl):S30-S37. doi: 10.4103/ijmr.IJMR_1812_15.
BACKGROUND & OBJECTIVE: It has been shown that the combined use of alcohol before radiofrequency ablation (RFA) helps to augment the therapeutic advantage of RFA. The present study was conducted to compare the outcome of treatment with RFA alone and RFA with alcohol as ablative technique in patients with small hepatocellular carcinomas (HCCs), who were not candidates for surgery.
METHODS
Fifty patients with chronic liver disease and concurrent HCC were enrolled in this prospective study. The patients were treated with either RFA alone (n=25) or RFA combined with alcohol (n=25). Patient outcome was evaluated, and the tumour recurrence and survival of the patients were assessed in the two groups.
RESULTS
The survival rates at six months in patients who completed at least six months of follow up were 84 and 80 per cent in patients treated with RFA alone and combination therapy, respectively. During the follow up period, 11 and four patients treated with RFA alone showed local and distant intrahepatic tumour recurrence, respectively. All local recurrences were at one to 18 months of the follow up period. The distant recurrences occurred at 6-36 months of the follow up period. During the follow up period, eight and six patients treated with combination therapy showed local and distant intrahepatic tumour recurrence, respectively. All local recurrences were at 1.5-15 months during the follow up period. The distant intrahepatic recurrences occurred at 6-72 months during the follow up period.
INTERPRETATION & CONCLUSIONS: No significant difference was seen between the survival time of the patients treated with RFA alone and RFA with alcohol as well as in the local recurrences and distant intrahepatic recurrences in RFA compared to RFA and alcohol group patients. Combined use of RFA and alcohol did not improve the local tumour control and survival in patients with HCC compared to RFA alone.
背景与目的
研究表明，射频消融（RFA）前联合应用酒精有助于增强 RFA 的治疗优势。本研究旨在比较单独 RFA 治疗与 RFA 联合酒精消融技术治疗不能手术的小肝细胞癌（HCC）患者的疗效。
方法
本前瞻性研究纳入了 50 例慢性肝病合并 HCC 患者。将患者分为单独 RFA 治疗组（n=25）和 RFA 联合酒精消融治疗组（n=25）。评估两组患者的治疗效果，观察肿瘤复发和生存情况。
结果
至少完成 6 个月随访的患者，RFA 单独治疗组和联合治疗组的 6 个月生存率分别为 84%和 80%。随访期间，RFA 单独治疗组有 11 例和 4 例患者分别出现局部和远处肝内肿瘤复发，所有局部复发均发生在随访的 1-18 个月内，远处复发发生在随访的 6-36 个月内。联合治疗组有 8 例和 6 例患者分别出现局部和远处肝内肿瘤复发，所有局部复发均发生在随访的 1.5-15 个月内，远处肝内复发发生在随访的 6-72 个月内。
结论与解释
单独 RFA 治疗组和 RFA 联合酒精消融治疗组患者的生存时间以及 RFA 组与 RFA 联合酒精消融组患者的局部复发和远处肝内复发无显著差异。与单独 RFA 相比，RFA 联合酒精消融并不能改善 HCC 患者的局部肿瘤控制和生存。
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