Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China.
Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China.
Acad Radiol. 2019 Feb;26(2):224-231. doi: 10.1016/j.acra.2018.04.007. Epub 2018 Jun 12.
To evaluate the method and effectiveness of Angio-CT-guided transcatheter arterial chemoembolization (TACE) immediately in combination with radiofrequency ablation (RFA) in the treatment of large hepatocellular carcinomas (HCCs; maximum enhancing diameter >5 cm).
A retrospective analysis was conducted on 48 patients with solitary large HCCs who were admitted from October 2012 to June 2016 and treated by immediate combination therapy, and 48 patients with solitary large HCCs who were treated by a sequential combination (RFA at 2-4 weeks after TACE) therapy in the same period were randomly selected as controls. After treatment, the success rates of the immediately combined technique, the short-term outcomes of the immediately combined treatment (using the modified response evaluation criteria in solid tumor standard), and the survival rates were evaluated.
The success rate of the immediately combined technique was 100%. The complete remission rates 1, 3, and 6 months after treatment in the study group were 58.3%༌56.2%, and 47.9%, respectively, while the corresponding complete remission rates of control group were 37.5%, 33.3%, and 27.1%, respectively. The 1-, 2-, and 3-year survival rates of the study group were 95.8%, 85.4%, and 58.3%, respectively, while the corresponding survival rates of the control group were 83.3%, 68.7%, and 43.8%, respectively. None of the patients had any serious complications.
Angio-CT-guided TACE immediately in combination with RFA is a feasible, safe method for the treatment of large HCCs with excellent short-term outcomes and improved long-term prognoses.
评估血管造影 CT 引导下经导管肝动脉化疗栓塞术（TACE）即刻联合射频消融（RFA）治疗大肝癌（最大增强直径＞5cm）的方法和疗效。
回顾性分析 2012 年 10 月至 2016 年 6 月收治的 48 例单发大肝癌患者，采用即刻联合治疗，并随机选择同期 48 例采用序贯联合（TACE 后 2-4 周行 RFA）治疗的患者作为对照。治疗后，评估即刻联合技术的成功率、即刻联合治疗的近期疗效（采用实体瘤改良疗效评价标准）和生存率。
即刻联合技术的成功率为 100%。研究组治疗后 1、3、6 个月的完全缓解率分别为 58.3%、56.2%和 47.9%，对照组分别为 37.5%、33.3%和 27.1%。研究组的 1、2、3 年生存率分别为 95.8%、85.4%和 58.3%，对照组分别为 83.3%、68.7%和 43.8%。所有患者均未发生严重并发症。
血管造影 CT 引导下 TACE 即刻联合 RFA 是治疗大肝癌的一种可行、安全的方法，具有良好的近期疗效和改善的长期预后。
