[1]王健 宋莉* 佟小强 杨敏 王超 牛国晨 闫子光 吕天石 关海涛 吕永兴 邹英华.肝动脉化疗栓塞联合射频消融治疗直径>5 cm的原发性肝癌[J].中国微创外科杂志,2015,15(10):878-882.
　Wang Jian,Song Li,Tong Xiaoqiang,et al.Transarterial Chemoembolization Combined with Radiofrequency Ablation for Hepatocellular Carcinoma Bigger Than 5 cm[J].Chinese Journal of Minimally Invasive Surgery,2015,15(10):878-882.
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肝动脉化疗栓塞联合射频消融治疗直径>5 cm的原发性肝癌()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年10期
页码:
878-882
栏目:
临床论著
出版日期:
2015-10-20

文章信息/Info

Title:
Transarterial Chemoembolization Combined with Radiofrequency Ablation for Hepatocellular Carcinoma Bigger Than 5 cm
作者:
王健 宋莉* 佟小强 杨敏 王超 牛国晨 闫子光 吕天石 关海涛 吕永兴 邹英华
（北京大学第一医院介入血管外科，北京100034）
Author(s):
Wang Jian;  Song Li;  Tong Xiaoqiang;  et al.
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing 100034, China
关键词:
肝脏; 肝细胞肝癌; 射频消融术; 经动脉化疗栓塞术
Keywords:
Liver; Hepatocellular carcinoma; Radiofrequency ablation; Transarterial chemoembolization
分类号:
R735.7
文献标志码:
A
摘要:
目的探讨肝动脉化疗栓塞（transarterial chemoembolization，TACE)联合射频消融（radiofrequency ablation，RFA)对于直径>5 cm的肝细胞肝癌（hepatocellular carcinoma，HCC)的治疗效果。方法回顾性分析2007年1月~2014年1月30例直径>5 cm的HCC患者资料，年龄34~83岁，（58.4±12.7）岁。肝内肿瘤均为单发，直径5~17 cm，（7.0±2.6）cm。肝功能Child-Pugh评分A级19例，B级11例。患者一般状态卡氏功能状态（Karnofsky performance status，KPS）评分70~100分，（88.6±10.3）分。治疗顺序：先行TACE治疗，TACE后适时给予RFA。随访过程中如发现肿瘤局部残存或复发，仍行TACE结合RFA治疗。随访终点事件为患者死亡或随访期结束（2014年1月）。采用Kaplan-Meier法进行生存期分析，并对随访结束时尚存活患者的Child-Pugh评分和KPS评分进行治疗前后的统计学比较。结果经TACE和RFA联合治疗后，30例初始病灶中完全灭活23例（76.7%），未完全灭活7例（23.3%）。随访期内24例（80%）出现肝内新发病灶，6例（20%）未再出现新发病灶。至随访终止，完全缓解（complete remission，CR)9例（30%），部分缓解（partial remission，PR)1例（3.3%），疾病进展（progression of disease，PD)7例（23.3%），死亡13例（43.3%）。存活患者随访期内Child-Pugh评分及KPS评分变化无统计学意义（P>0.05）。全组随访时间13~60个月，（34.1±14.1）月。中位生存期48个月（95% CI 34~62个月）。1、3、5年生存率分别为96.7%、69.5%、33.2%。结论本研究进一步证实TACE联合RFA安全有效，可以控制HCC患者肝内病变的进展，改善其生活质量，生存期数据满意。对于直径>5 cm的HCC患者，TACE联合RFA是有效的治疗手段之一。
Abstract:
ObjectiveTo investigate the efficacy and safety of radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) bigger than 5 cm.MethodsFrom January 2007 to January 2014, thirty HCC patient with lesion diameter bigger than 5 cm were enrolled in this study. The age ranged 34-83 years old (mean, 58.4±12.7 years old). The tumor size was 5-17 cm (mean, 7.0±2.6 cm). The liver function was assessed by the Child-Pugh scores, with A in 19 cases and B in 11 cases. And clinical status of each patient was evaluated by the Karnofsky performance status (KPS) scores showing 70-100 points (mean, 88.6±10.3 points). For all the lesions, RFA was given at appropriate time after TACE. If residual lesions or recurrent lesions were found during follow-up period, TACE+RFA was given repeatedly when possible. The KPS scores and Child-Pugh scores were evaluated by the end of the follow up. The estimated overall survival and medians for survival time was analyzed statistically.ResultsAmong the 30 initial lesions, complete ablation was achieved in 23 cases (76.7%) and partial ablation in 7 (23.3%). During the follow-up period, new lesions developed in 24 patients (80%) and no reemergence of lesions in 6 patients (20%). Among the whole group, complete remission (CR) was obtained in 9 cases (30%), partial remission (PR) 1 case (3.3%), progression of disease (PD) in 7 cases (23.3%), and death in 13 cases (43.3%). The follow-up time was 13-60 months (mean, 34.1±14.1 months). The estimated median survival time was 48 months (95% CI: 34-62 months). The 1-, 3- and 5-year survival rates for whole group were 96.7%, 69.5%, and 332%, respectively.ConclusionsFor patients with HCC bigger than 5 cm, RFA+TACE can effectively control the local lesion. The estimated overall survival is excellent.

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备注/Memo

备注/Memo:
基金项目：北京大学-清华大学生命科学联合中心临床青年人才培育项目（201301018）*通讯作者，E-mail：vanjian0987@sina.com
更新日期/Last Update: 2016-02-03