经皮微波消融与射频消融治疗毗邻大血管肝癌的比较：一项回顾性研究。

Comparison of percutaneous microwave ablation with radiofrequency ablation for hepatocellular carcinoma adjacent to major vessels: A retrospective study.

机构信息

Department of Ultrasonic Intervention, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Changhai Rd, Shanghai, China.

Department of Ultrasonography, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Changhai Rd, Shanghai, China.

出版信息

J Cancer Res Ther. 2022 Apr;18(2):329-335. doi: 10.4103/jcrt.jcrt_1466_21.

DOI:10.4103/jcrt.jcrt_1466_21

PMID:35645097

Abstract

PURPOSE

To compare the therapeutic efficacy and safety of percutaneous microwave ablation (MWA) with those of percutaneous radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) adjacent to major vessels.

METHODS

From January 2010 to April 2011, 78 patients with a single nodule, no >5 cm, adjacent to major vessels were enrolled in this study. Forty-four patients (forty-one men, three women; age range, 33-72 years) treated by MWA were compared with thirty-four patients (thirty-one men, three women; age range, 33-75 years) treated by RFA. Local tumor progression rate, overall survival rate, and disease-free survival rate were calculated using the Kaplan-Meier method, and differences between groups were estimated by log-rank test.

RESULTS

No death related to treatment occurred in the two groups. The 1-, 2-, and 3-year local tumor progression rates were 6.8%, 11.4%, and 15.9%, respectively, in the microwave group versus 17.6%, 20.6%, and 20.6%, respectively in the radiofrequency group (P = 0.544). The rates of major complications associated with microwave and RFA were 2.3% (1/44) versus 0% (0/34; P = 0.376). The microwave group's 1-, 2-, and 3-year disease-free survival rates were 72.7%, 65.9%, and 51.8%, respectively, and those in the radiofrequency were 58.8%, 52.9%, and 47.1%, respectively (P = 0.471). The microwave group's 1-, 2-, and 3-year overall survival rates were 93.2%, 90.9%, and 83.6%, respectively, and those in the radiofrequency group were 91.2%, 88.2%, and 82.4%, respectively (P = 0.808) There was no significant difference in local tumor progression, complications related to treatment, and long-term results between the two modalities. The incidence of peritumoral structure damage on image scan was significantly higher in the microwave group than in the RFA group (P = 0.025).

CONCLUSIONS

Both RFA and MWA are safe and effective techniques for HCC adjacent to major vessels and have the same clinical value.

摘要

目的

比较经皮微波消融（MWA）与经皮射频消融（RFA）治疗毗邻大血管肝细胞癌（HCC）的疗效和安全性。

方法

2010 年 1 月至 2011 年 4 月，共纳入 78 例单个结节、直径不超过 5cm、毗邻大血管的 HCC 患者。44 例（41 例男性，3 例女性；年龄 33-72 岁）接受 MWA 治疗，34 例（31 例男性，3 例女性；年龄 33-75 岁）接受 RFA 治疗。采用 Kaplan-Meier 法计算局部肿瘤进展率、总生存率和无病生存率，采用对数秩检验比较两组间差异。

结果

两组均无治疗相关死亡。MWA 组 1、2、3 年局部肿瘤进展率分别为 6.8%、11.4%和 15.9%，RFA 组分别为 17.6%、20.6%和 20.6%（P=0.544）。MWA 和 RFA 相关主要并发症发生率分别为 2.3%（1/44）和 0%（0/34；P=0.376）。MWA 组 1、2、3 年无病生存率分别为 72.7%、65.9%和 51.8%，RFA 组分别为 58.8%、52.9%和 47.1%（P=0.471）。MWA 组 1、2、3 年总生存率分别为 93.2%、90.9%和 83.6%，RFA 组分别为 91.2%、88.2%和 82.4%（P=0.808）。两种方法在局部肿瘤进展、治疗相关并发症和长期疗效方面无显著差异。MWA 组在图像扫描上显示肿瘤周围结构损伤的发生率明显高于 RFA 组（P=0.025）。