经动脉化疗栓塞联合射频消融法治疗对较大原发性肝癌疗效分析
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摘要
目的明确经动脉化疗栓塞(TACE)联合射频消融(RFA)或单用RFA治疗较大体积原发性肝癌的减瘤效果及患者远期生存质量。方法选取2008年7月—2016年4月我院收治的较大肝癌患者86例,按治疗方式不同分为观察组和对照组,每组43例。观察组采用TACE+RFA,对照组单用RFA。治疗结束后比较2组相应生化指标、患者无进展生存期和ECOG生存质量指标。结果观察组术后7天肿瘤标志物相关指标下降程度优于治疗前和对照组,远期生存质量优于对照组(P<0.05)。2组肝功能指标及半年内生存质量比较差异无统计学意义(P>0.05)。结论 TACE联合RFA对较大原发性肝癌患者的肝功能影响较小、减瘤效果明显,能较好地延长患者无进展生存期。
Objective To investigate anti-tumor effect of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) or RFA only in treatment of patients with comparatively large primary liver cancer and to analyze long-term survival quality of the patients. Methods A total of 86 patients with comparatively large liver cancer admitted during July 2008 and April 2016 were divided into observation group(n=43, TACE+RFA) and control group(n=43, RFA only). At the end of treatment, corresponding biochemical indexes, the progression-free survival duration and life quality index of Eastern Cooperative Oncology Group(ECOG) were compared between two groups. Results In observation group on the 7~(th) d after treatment, related indicators of tumor markers showed more significant decrease compared with those before treatment in the same group and in control group, while long-term survival quality was better than that in control group(P<0.05). There were no significant differences in effects on liver function and life quality of patients within half a year between two groups(P>0.05). Conclusion TACE combined with RFA has little effect on liver function in patients with comparatively large primary liver cancer with obvious anti-tumor effect, and it may better delay patients' progression-free survival duration.
Objective To investigate anti-tumor effect of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) or RFA only in treatment of patients with comparatively large primary liver cancer and to analyze long-term survival quality of the patients. Methods A total of 86 patients with comparatively large liver cancer admitted during July 2008 and April 2016 were divided into observation group(n=43, TACE+RFA) and control group(n=43, RFA only). At the end of treatment, corresponding biochemical indexes, the progression-free survival duration and life quality index of Eastern Cooperative Oncology Group(ECOG) were compared between two groups. Results In observation group on the 7~(th) d after treatment, related indicators of tumor markers showed more significant decrease compared with those before treatment in the same group and in control group, while long-term survival quality was better than that in control group(P<0.05). There were no significant differences in effects on liver function and life quality of patients within half a year between two groups(P>0.05). Conclusion TACE combined with RFA has little effect on liver function in patients with comparatively large primary liver cancer with obvious anti-tumor effect, and it may better delay patients' progression-free survival duration.
引文
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[17] 朱楠,鲁东,肖景坤,等.肝动脉化疗栓塞联合射频消融术治疗中晚期肝癌的疗效[J].中国介入影像与治疗学,2017,14(4):195-199.
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[19] Yuan W,Yang M J,Xu J,et al.Radiofrequency Ablation Combined With Transarterial Chemoembolization for Specially Located Small Hepatocellular Carcinoma.Technol Cancer Res Treat [J].Technol Cancer Res Treat,2018,17:1533033818788529.
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[2] Saviano A,Iezzi R,Giuliante F,et al.Liver Resection versus Radiofrequency Ablation plus Transcatheter Arterial Chemoembolization in Cirrhotic Patients with Solitary Large Hepatocellular Carcinoma[J].J Vasc Interv Radiol,2017,28(11):1512-1519.
[3] 欧杰,诸佳瑜,林恒红,等.原发性肝癌中医证型与ECOG评分相关性研究[J].辽宁中医药大学学报,2016,18(11):94-97.
[4] Uchino K,Tateishi R,Nakagomi R,et al.Serum levels of ferritin do not affect the prognosis of patients with hepatocellular carcinoma undergoing radiofrequency ablation[J].PLoS One,2018,13(7):e0200943.
[5] Imai K,Beppu T,Chikamoto A,et al.Comparison between hepatic resection and radiofrequency ablation as first-line treatment for solitary small-sized hepatocellular carcinoma of 3 cm or less[J].Hepatol Res,2013,43(8):853-864.
[6] 徐志宾,高万勤.大肝癌4种微创疗法的近期疗效对比[J].中国中西医结合影像学杂志,2016,14(5):524-526.
[7] 王勋,王松,罗英,等.介入栓塞联合射频消融治疗肝巨大局灶性结节性增生的疗效评价[J].解放军医学院学报,2018,39(6):461-464,476.
[8] 吴薇,李荣杰,杨薇,等.经皮射频消融治疗邻近膈顶较大肝癌[J].中国介入影像与治疗学,2018,15(1):15-18.
[9] 孙贤俊,何胜利,陈颢.射频消融治疗大肝癌疗效的临床研究现状[J].中西医结合肝病杂志,2011,21(2):123-126.
[10] 张敏,陈威,刘俊莉.大肝癌根治术前先行射频消融保守治疗的可行性[J].实用医学杂志,2017,33(17):2881-2884.
[11] 赵丽,宁刚,郭庆良,等.开腹射频消融综合治疗不可切除大肝癌探讨[J].医学理论与实践,2018,31(4):478-480.
[12] Takuma Y,Takabatake H,Morimoto Y,et al.Comparison of combined transcatheter arterial chemoembolization and radiofrequency ablation with surgical resection by using propensity score matching in patients with hepatocellular carcinoma within Milan criteria[J].Radiology,2013,269(3):927-937.
[13] 沈桢,阎皓.大功率微波消融联合动脉化疗栓塞介入治疗中大肝癌疗效及安全性研究[J].解放军医药杂志,2016,28(10):31-35.
[14] 李晓光.肝癌消融联合靶向药物治疗[J].肝癌电子杂志,2017,4(4):21-26.
[15] 马玉靖,张昕,苏国宏,等.阿霉素热敏脂质体联合射频消融治疗肝癌的研究进展[J].中华普通外科杂志,2018,33(2):182-184.
[16] 吴薇,陈敏华.难治性肝癌射频消融治疗策略[J].中国介入影像与治疗学,2018,15(1):13-14.
[17] 朱楠,鲁东,肖景坤,等.肝动脉化疗栓塞联合射频消融术治疗中晚期肝癌的疗效[J].中国介入影像与治疗学,2017,14(4):195-199.
[18] 高飞,庞志刚,韩斌,等.肝动脉化疗栓塞联合射频消融术治疗大肝癌的疗效及生存分析[J].介入放射学杂志,2016,25(4):316-319.
[19] Yuan W,Yang M J,Xu J,et al.Radiofrequency Ablation Combined With Transarterial Chemoembolization for Specially Located Small Hepatocellular Carcinoma.Technol Cancer Res Treat [J].Technol Cancer Res Treat,2018,17:1533033818788529.
[20] Yuan H,Liu F,Li X,et al.Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided radiofrequency ablation in the treatment of solitary large hepatocellular carcinoma[J].Radiol Med,2018,124(1):1-7.