Pang Qingqing, Luo Wenping, Chen Shaojun, Zhou Hua, Zhang Riguang, Li Yueyong, Zhao Jianbo, Yuan Chunwang, Wang Guodong
Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Department of Blood Transfusion, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Front Oncol. 2025 Jul 28;15:1530951. doi: 10.3389/fonc.2025.1530951. eCollection 2025.
To evaluate the safety and short-term clinical efficacy of drug-loaded polyvinyl alcohol microspheres transarterial chemoembolization (D-TACE) in the treatment of unresectable large liver carcinoma with sequential double-needle water-cooled circulating radiofrequency ablation (D-RFA).
A retrospective analysis was performed for patients with large hepatocellular carcinoma who underwent sequential D-TACE with D-RFA treatment at our hospital. From May 2019 to May 2023, a total of 143 intrahepatic malignant lesions were treated, and a total of 110 D-TACE and 96 D-RFA interventional therapy procedures were performed. The short-term efficacy at 1, 3, and 6 months after interventional therapy was analyzed based on the modified Response Evaluation Criteria in Solid Tumor (2020 edition) criteria. The evaluation included the efficacy of local tumor control, feasibility of technical implementation, safety of surgery, and tolerability by surgical patients.
Sixty-two patients underwent successful interventional therapy, achieving good technical feasibility. The objective response rate (ORR) at 3, 6, and 12 months was 90.4%, 85.5%, and 74.2%, respectively. The median overall survival (OS) was 35.0 months (95% CI: 24.7-45.3). The survival rates at 3, 6, and 12 months were 100% (62/62), 96.7% (60/62), and 93.5% (58/62), respectively. No cases of death occurred due to serious complications such as ectopic embolism, tumor rupture, or liver failure within 1 month after surgery. Two cases of postoperative tumor lysis syndrome, 3 cases of pleural effusion caused by intercostal artery injury, and 4 cases of small effusion in the abdominal cavity were reported. Eight cases of mild, moderate, and severe abdominal pain during or after the operation; 6 cases had mild to moderate liver function impairment. Eight patients experienced fever within 1 week after surgery.
The D-TACE with sequential D-RFA technique for the treatment of unresectable large liver cancer is safe and controllable, with a high ORR. This combination treatment provides a useful reference value for the exploration of new treatment modes for advanced liver cancer, but the long-term efficacy evaluation requires multi-center, large-sample clinical studies, and continuous follow-up data analysis.
评估载药聚乙烯醇微球经动脉化疗栓塞术（D-TACE）联合序贯双针水冷循环射频消融术（D-RFA）治疗不可切除的大肝癌的安全性和短期临床疗效。
对我院接受序贯D-TACE联合D-RFA治疗的大肝细胞癌患者进行回顾性分析。2019年5月至2023年5月，共治疗143个肝内恶性病灶，共进行110次D-TACE和96次D-RFA介入治疗。根据改良实体瘤疗效评价标准（2020版）分析介入治疗后1、3和6个月的短期疗效。评估内容包括局部肿瘤控制疗效、技术实施可行性、手术安全性以及手术患者的耐受性。
62例患者介入治疗成功，技术可行性良好。3、6和12个月时的客观缓解率（ORR）分别为90.4%、85.5%和74.2%。中位总生存期（OS）为35.0个月（95%CI：24.7-45.3）。3、6和12个月时的生存率分别为100%（62/62）、96.7%（60/62）和93.5%（58/62）。术后1个月内无因异位栓塞、肿瘤破裂或肝衰竭等严重并发症导致死亡的病例。报告了2例术后肿瘤溶解综合征、3例因肋间动脉损伤引起的胸腔积液和4例腹腔少量积液。8例患者在手术期间或术后出现轻、中、重度腹痛；6例患者有轻度至中度肝功能损害。8例患者术后1周内发热。
序贯D-RFA技术的D-TACE治疗不可切除的大肝癌安全可控，ORR高。这种联合治疗为晚期肝癌新治疗模式的探索提供了有用的参考价值，但长期疗效评估需要多中心、大样本临床研究及持续的随访数据分析。
