From the Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, 250 East Changgang Rd, Guangzhou, Guangdong 510260, China (K.Z., J.H., W.H., M.C., J.Z., Y.G.); Department of Radiology, Guangzhou First Municipal People's Hospital, Guangzhou, China (L.L.); and Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (J.C.).
Radiology. 2018 Jul;288(1):300-307. doi: 10.1148/radiol.2018172028. Epub 2018 Apr 24.
Purpose To determine the safety and efficacy of sorafenib combined with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) (hereafter, S-TACE-RFA) in patients with medium or large (range, 3.1-7.0 cm in diameter) hepatocellular carcinoma (HCC). Materials and Methods This retrospective study evaluated the medical records of consecutive patients with medium or large HCC who underwent S-TACE-RFA or combined TACE and RFA (hereafter, TACE-RFA) from January 2010 to December 2014. Sorafenib was started 3-5 days after TACE, and RFA was performed 1-2 weeks after TACE. Treatment complications, recurrence-free survival (RFS), and overall survival (OS) in patients who underwent S-TACE-RFA were compared with those in patients who underwent TACE-RFA. Results Of the 174 patients who underwent S-TACE-RFA or TACE-RFA, 106 who met the eligibility criteria were included in this study. Among them, 40 underwent S-TACE-RFA and 66 underwent TACE-RFA. The patients who underwent S-TACE-RFA had longer RFS (median, 24.0 vs 10.0 months; P = .04) and better OS (median, 63.0 vs 36.0 months, P = .048) than those who underwent TACE-RFA. S-TACE-RFA and α-fetoprotein level were independent prognostic factors for survival in uni- and multivariable analyses. The rate of complications in patients who underwent S-TACE-RFA was similar to that in patients who underwent TACE-RFA (22.5% vs 18.2%, P = .59). Conclusion S-TACE-RFA resulted in longer RFS and better OS than did TACE-RFA in patients with medium or large HCC. RSNA, 2018 Online supplemental material is available for this article.
评估索拉非尼联合经动脉化疗栓塞（TACE）和射频消融（RFA）（以下简称 S-TACE-RFA）治疗直径为 3.1-7.0cm 的中大型肝癌（HCC）患者的安全性和有效性。
本回顾性研究纳入了 2010 年 1 月至 2014 年 12 月期间接受 S-TACE-RFA 或联合 TACE 和 RFA（以下简称 TACE-RFA）治疗的连续中大型 HCC 患者的病历资料。TACE 后 3-5 天开始服用索拉非尼，TACE 后 1-2 周行 RFA。比较了 S-TACE-RFA 组和 TACE-RFA 组患者的治疗并发症、无复发生存（RFS）和总生存（OS）。
在 174 例接受 S-TACE-RFA 或 TACE-RFA 的患者中，有 106 例符合纳入标准。其中，40 例患者接受 S-TACE-RFA，66 例患者接受 TACE-RFA。S-TACE-RFA 组患者的 RFS（中位时间：24.0 个月比 10.0 个月；P=0.04）和 OS（中位时间：63.0 个月比 36.0 个月；P=0.048）均长于 TACE-RFA 组。单变量和多变量分析均显示，S-TACE-RFA 和甲胎蛋白水平是影响生存的独立预后因素。S-TACE-RFA 组患者的并发症发生率与 TACE-RFA 组患者相似（22.5%比 18.2%；P=0.59）。
S-TACE-RFA 治疗中大型 HCC 患者的 RFS 和 OS 长于 TACE-RFA。RSNA，2018 在线补充资料可供参考。
