经导管动脉化疗栓塞联合射频消融治疗肝细胞癌患者疗效研究*

doi:10.3969/j.issn.1672-5069.2023.05.025

摘要/Abstract

摘要： 目的比较采用经导管肝动脉化疗栓塞(TACE)联合射频消融(RFA)与TACE治疗肝细胞癌(HCC)患者的疗效。方法 2020年2月～2021年4月我院收治的HCC患者60例,其中20例接受TACE联合RFA治疗,另40例接受TACE治疗40例。术后,随访1年。结果治疗后,TACE联合RFA治疗组完全缓解率、部分缓解率和有效率分别为35.0%、40.0%和75.0%,显著高于TACE治疗组的20.0%、25.0%和45.0% (P＜0.05);联合组血清甲胎蛋白水平为(101.4±23.6)μg/L,显著低于TACE治疗组【(364.2±45.6)μg/L,P＜0.05】;在TACE或联合RFA治疗后,出现胸腔积液、皮肤灼伤、术后疼痛、一过性血清转氨酶或胆红素轻度升高,均经对症处理后缓解或消失,未出现严重的并发症;TACE联合RFA治疗组1 a生存率为70.0%(14/20),显著高于TACE治疗组的40.0%(16/40),差异具有统计学意义(P＜0.05)。结论采用TACE联合RFA治疗HCC患者有效,能显著提高短期生存率,值得进一步观察。

关键词: 肝细胞癌, 经导管动脉化疗栓塞, 射频消融, 治疗

Abstract: Objective The aim of this study was to investigate the short-term outcomes of patients with hepatocellular carcinoma (HCC) after undergoing transcatheter hepatic arterial chemoembolization (TACE) and radiofrequency ablation (RFA) combination therapy. Methods 60 patients with HCC were encountered in our hospital between February 2020 and April 2021, and out of them, 20 patients received TACE and thereafter RFA, and 40 underlying materials-matched patients received TACE alone during the same period. All patients with HCC were followed-up for 12 months. Results After treatment, the complete remission rate, partial remission rate and effectiveness rate in patients having TACE and RFA combination therapy were 35.0%, 40.0% and 75.0%, all significantly higher than 20.0%, 25.0% and 45.0% (P＜0.05) in TACE-treated patients; serum alpha-fetoprotein level in TACE and RFA-treated patients was (101.4±23.6)μg/L, significantly lower than [(364.2±45.6)μg/L, P＜0.05] in TACE-treated patients; the common complications after TACE or TACE and RFA combination in our series were pleural effusion, skin burning, local pains and transient serum ALT and/or bilirubin level elevation, all disappeared after appropriate management; the one-year survival rate in TACE and RFA-treated patients was 70.0% (14/20), much higher than 40.0% (16/40) in TACE-treated patients (P＜0.05). Conclusion The TACE and RFA combination therapy in the treatment of patients with HCC is efficacious, which might improve the short-term survival, and warrants further clinical investigation.

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

武向慧, 李龙虎, 景斐华, 武鹏. 经导管动脉化疗栓塞联合射频消融治疗肝细胞癌患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 702-705.

Wu Xianghui, Li Longhu, Jing Feihua, et al. One-year survival of patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization and radiofrequency ablation combination therapy[J]. Journal of Practical Hepatology, 2023, 26(5): 702-705.

参考文献

[1] Kim DW, Talati C, Kim R. Hepatocellular carcinoma (HCC): beyond sorafenib-chemotherapy. J Gastrointest Oncol, 2017, 8(2):256-265.
[2] Wang W, Wei C. Advances in the early diagnosis of hepatocellular carcinoma. Genes Dis, 2020, 7(3):308-319.
[3] Kuang J, Wan D, Wan P, et al. Efficacy of sorafenib combined with transcatheter hepatic arterial chemoembolization in treating intermediate-advanced hepatocellular carcinoma. J BUON, 2021, 26(3):868-874.
[4] Chang KT, Liu CJ, Tsai HT, et al. Effects and safety of body positioning on back pain after transcatheter arterial chemoembolization in people with hepatocellular carcinoma: A randomized controlled study. Int J Nurs Stud, 2020, 109:103641.
[5] 周彬彬, 孙姚晨, 黄海帆, 等. TACE术后肝细胞癌患者功能磁共振成像参数变化研究. 实用肝脏病杂志, 2020, 23(5):723-726.
[6] Lee J, Shin IS, Yoon WS, et al. Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies: Meta-analyses and a systematic review. Radiother Oncol, 2020, 145:63-70.
[7] Solbiati L, Ierace T, Gennaro N, et al. Percutaneous radiofrequency ablation of HCC: reduced ablation duration and increased ablation size using single, internally cooled electrodes with an optimized pulsing algorithm. Int J Hyperthermia, 2020, 37(1):861-867.
[8] Llovet JM, Lencioni R. mRECIST for HCC: Performance and novel refinements. J Hepatol, 2020, 72(2):288-306.
[9] Lin SM. Local ablation for hepatocellular carcinoma in Taiwan. Liver Cancer, 2013, 2(2):73-83.
[10] Liu B, Zhang Y, Chen H, et al. The combination of transcatheter arterial chemoembolisation (TACE) and thermal ablation versus TACE alone for hepatocellular carcinoma. Cochrane Database Syst Rev, 2022, 1(1): CD013345.
[11] Zhang X, Wang K, Wang M, et al. Transarterial chemoembolization (TACE) combined with sorafenib versus TACE for hepatocellular carcinoma with portal vein tumor thrombus: a systematic review and meta-analysis. Oncotarget, 2017, 8(17):29416-29427.
[12] Wu J, Li A, Yang J, et al. Efficacy and safety of TACE in combination with sorafenib for the treatment of TACE-refractory advanced hepatocellular carcinoma in Chinese patients: a retrospective study. Onco Targets Ther, 2017, 10:2761-2768.
[13] 赵健, 徐建波, 高志颖, 等. 肝细胞癌合并微血管侵犯肝切除术后辅助性TACE疗效的荟萃分析. 中华肝胆外科杂志, 2020, 26(1):38-43.
[14] 刘鹏, 解宇威, 张露旬, 等. 预防性肝动脉化疗栓塞联合抗肿瘤药物对合并微血管侵犯肝癌术后近期复发的影响. 中华肝胆外科杂志, 2021, 27(9):652-657.
[15] Zheng L, Fang S, Wu F, et al. Efficacy and safety of TACE combined with sorafenib plus immune checkpoint inhibitors for the treatment of intermediate and advanced TACE-refractory hepatocellular carcinoma: A retrospective study. Front Mol Biosci, 2021, 7:609322.
[16] Liu C, Li T, He JT, et al. TACE combined with microwave ablation therapy vs. TACE alone for treatment of early- and intermediate-stage hepatocellular carcinomas larger than 5 cm: a meta-analysis. Diagn Interv Radiol, 2020, 26(6):575-583.
[17] 黄建生, 马宽生. 射频消融治疗肝癌的并发症及其防治措施. 中华肝脏病杂志, 2012, 20(4):248-250.
[18] Bertot LC, Sato M, Tateishi R, et al. Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review. Eur Radiol, 2011, 21(12):2584-2596.
[19] 王永华, 吴庭苗. 经导管肝动脉化疗栓塞术联合¹²⁵I 放射性粒子治疗肝癌的临床应用现状及进展. 中华核医学与分子影像杂志, 2019, 39(2):112-115.
[20] Solbiati L, Ierace T, Gennaro N, et al. Percutaneous radiofrequency ablation of HCC: reduced ablation duration and increased ablation size using single, internally cooled electrodes with an optimized pulsing algorithm. Int J Hyperthermia, 2020, 37(1):861-867.

经导管动脉化疗栓塞联合射频消融治疗肝细胞癌患者疗效研究^*

One-year survival of patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization and radiofrequency ablation combination therapy

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	盛秋菊, 窦晓光. 慢性HBV感染不同疾病状态治疗策略选择与获益评价[J]. 实用肝脏病杂志, 2023, 26(5): 609-611.
[2]	张丹, 丁洋. 慢性乙型肝炎患者病毒载量与疾病状态和治疗策略选择^*[J]. 实用肝脏病杂志, 2023, 26(5): 612-614.
[3]	彭真, 宁会彬, 李宽, 尚佳. HBeAg阳性慢性HBV 感染分期和治疗新进展[J]. 实用肝脏病杂志, 2023, 26(5): 615-617.
[4]	吴育龙, 庄见齐, 刘志成, 马侠槟. 核苷(酸)类似物治疗慢性乙型肝炎患者血清HBV pgRNA变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(5): 622-625.
[5]	王一卓, 张崴琪, 李红. 聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患者3年随访研究[J]. 实用肝脏病杂志, 2023, 26(5): 626-629.
[6]	李亚玲, 杨发成, 蒋亚西. 直接抗病毒药物治疗慢性丙型肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 638-641.
[7]	蔡涛, 魏玮, 王欣雯, 王玥坤, 秦军, 蓝晓红. 直接抗病毒药物治疗慢性终末期肾病合并慢性丙型肝炎患者疗效初步研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 642-645.
[8]	罗良德, 苏建明, 任成果, 申红. 复方甘草酸苷联合非诺贝特治疗代谢相关性脂肪性肝病患者疗效及其对脂代谢的影响^*[J]. 实用肝脏病杂志, 2023, 26(5): 650-653.
[9]	莫俊俏, 林景, 羊莉. 水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗抗结核药物所致药物性肝损伤患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 666-669.
[10]	秦浩, 方春华, 张磊, 冉斌, 汪丽萍, 罗凌, 李应, 黄育红. 乙型肝炎病毒相关肝细胞癌癌组织ARHGAP18水平及其基因调控网络分析^*[J]. 实用肝脏病杂志, 2023, 26(5): 694-697.
[11]	陈长广, 肖荣, 王俊. DEB-TACE序贯射频消融治疗原发性肝癌患者效果研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 706-709.
[12]	张树庚, 张少博, 朱泽斌, 栗雪峰, 蔡伟, 郭亚飞, 刘连新. Clavien-Dindo分级系统分析不同供肝类型肝移植患者术后早期并发症发生率比较研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 738-741.
[13]	叶超荣, 张涛, 吴永军, 利民. LCBDE与ERCP术治疗胆总管结石患者效果研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 742-745.
[14]	宋巍, 李智德, 李玉鹏, 陈雄. 吲哚菁绿荧光显像指导腹腔镜胆囊切除术治疗胆囊良性疾病患者效果研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 746-749.
[15]	黄龙, 范雅茜, 段钟平. 舒肝宁注射液利胆退黄抗炎护肝机制研究进展^*[J]. 实用肝脏病杂志, 2023, 26(5): 765-768.