肝动脉化疗栓塞联合射频消融治疗大肝癌的疗效评价

摘要

目的 探讨经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合射频消融(radiofrequency ablation,RFA)治疗大肝癌的临床应用价值.方法 回顾性分析我院2006年4月至2008年7月收治的66例肝细胞癌患者的治疗结果,根据治疗方法分为TACE+ RFA组、TACE组及RFA组,其中19例行RFA联合TACE治疗(TACE+RFA组),24例单纯TACE治疗(TACE组),23例单纯RFA治疗(RFA组).结果 TACE+RFA组的肿瘤坏死率达73.68％,明显高于单纯TACE组及单纯RFA组(分别为50.00％,52.17％,P＜0.01,P＜0.05).局部复发率分别为26.32％、37,50％和 30.43％,三组间无显著统计学差异(P＞0.05).TACE+RFA组的平均生存期为28.3个月,显著高于TACE组的13.6个月(P＜ 0.01)和单纯RFA组的21.7个月(P＜0.05).结论 TACE联合RFA治疗大肝癌与单纯TACE和单纯RFA治疗效果相比,可提高肿瘤坏死率,延长患者生存期.%Objective To evaluate the efficacy of tanscatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma. Methods A retrospective analysis was performed of 66 patients with hepatocellular carcinoma who received different treatments during April 2006-July 2008. The patients were divided into 3 groups: 19 patients in TACE + RFA group, 24 patients in TACE group, and 23 patients in RFA group. Results The complete necrosis rate of tumor accounted for 73.68% in TACE + RFA group which was significantly higher than that of TACE group and RFA group (50.00%, and 52.17%, respectively, P < 0.01, P < 0.05). The local recurrence rates of tumor in TACE + RFA group, TACE group, and RFA group were 26.32%, 37.5% and 30.43% (P > 0.05). Mean survival time of patients in TACE + RFA group was 28.3 months, which was higher than that of TACE group and RFA group (13.6 months, 21.7 months, P < 0.01, P < 0.05). Conclusion Percutaneous transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in primary large hepatocellular carcinoma could improve tumor complete necrosis rate and extend the patient's survival time.