实用肝脏病杂志 ›› 2017, Vol. 20 ›› Issue (4): 472-476.doi: 10.3969/j.issn.1672-5069.2017.04.023

• 肝癌 • 上一篇    下一篇

经导管肝动脉化疗栓塞联合射频消融治疗原发性肝癌患者临床疗效评价*

张伟, 陈刚, 孙密密, 安永, 王永清, 商庆华   

  1. 271000 山东省泰安市 解放军第88医院全军肝病诊治中心
  • 收稿日期:2016-11-08 出版日期:2017-07-10 发布日期:2017-07-07
  • 通讯作者: 商庆华,E-mail:shangqh@163.com
  • 作者简介:张伟,男,34岁,医学硕士,主治医师。主要从事肝脏疾病的诊疗研究。E-mail:15505386060@163.com
  • 基金资助:
    原济南军区“十一五”科研计划课题(编号:J115N009); 泰安市科技发展计划课题(编号:2015NS1132)

Clinical efficacy of TACE and radiofrequency ablation in treatment of patients with primary liver cancer

Zhang Wei, Chen Gang, Sun Mimi, et al.   

  1. Diagnosis and Treatment Centre for Liver Disease,88th Hospital,Tai'an 271000,Shandong Province,China
  • Received:2016-11-08 Online:2017-07-10 Published:2017-07-07

摘要: 目的 评价经导管肝动脉化疗栓塞(TACE)与射频消融(RFA)联合治疗原发性肝癌患者的临床疗效。方法 采用随机数字表法将60例原发性肝癌患者分为联合组30例和TACE组30例,分别给予TACE联合RFA或TACE治疗,对比分析两组患者的近期和远期临床疗效。结果 联合组完全缓解和部分缓解率分别为26.7%和50.0%,显著高于TACE组的6.7%和23.3%,差异均具有统计学意义(P<0.05);联合组患者生存时间为(2.86±0.48)年,显著长于TACE组的(0.93±0.27) 年,差异具有统计学意义(P<0.05);联合组患者治疗后1年、2年、3年血清AFP水平分别为(475.4±200.7) μg/L、(416.4±229.0) μg/L、(320.4±243.5) μg/L,显著低于TACE组的(639.1±190.9) μg/L、(623.4±234.6) μg/L、(674.4±300.2) μg/L,差异均具有统计学意义(P<0.05);联合组患者1 a、2 a、3 a生存率分别为86.7%、66.7%、56.7%,显著高于TACE组的46.7%、26.7%、10.0%,差异均具有统计学意义(P<0.05)。结论 TACE与RFA联合治疗原发性肝癌患者,临床疗效显著。

关键词: 原发性肝癌, 经导管肝动脉化疗栓塞, 射频消融, 治疗

Abstract: Objective To evaluate the clinical efficacy of TACE and radiofrequency ablation(RFA) in treatment of patients with primary liver cancer(PLC). Methods Sixty patients with PLC in the center of liver diseases in our hospital between April 2012 and March 2013 were randomly divided into two groups,with 30 cases in each group,and the patients were given RFA after TACE or TACE alone therapy. The short-and long-term clinical response were compared. Results There was no significant difference at baseline between the two groups as respect to gender,age,hepatitis B surface antigen positive,liver function index,α-fetoprotein (AFP),tumor numbers and tumor diameters(P>0.05);the complete and partial remission rates in the combination group(26.7% and 50.0%,respectively)were much higher than those(6.7% and 23.3%,respectively)in the TACE group (P<0.05);the survival periods in the combination group(2.86±0.48 years)was much longer than that (0.93±0.27 years)in the TACE group(P<0.05);serum AFP level at the end of first,second and third year after treatment in the combination group[(475.4±200.7) μg/L,(416.4±229.0) μg/L and (320.4±243.5) μg/L] were lower than those [(639.1±190.9) μg/L,(623.4±234.6) μg/L and(674.4±300.2 )μg/L] in TACE group (P<0.05);the 1 a,2 a and 3 a survival rates after treatment in the combination group(86.7%,66.7% and 56.7%) were significantly higher than those(46.7%,26.7% and 10.0%)in the TACE group(P<0.05). Conclusion Combination of TACE and RFA has a remarkable clinical efficacy for patients with PLC,which is worthy of further investigation.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Radiofrequency ablation, Therapy