|
|
TACE combined with CT guided percutaneous radiofrequency ablation for large liver carcinoma |
WU Bin, XU Dawei, WANG Lijun, JIN Wenhui, ZHOU Wenhua, MENG Liangliang |
Department of Radiology, Beijing Municipal Corps Hospital of Chinese People’s Armed Police Forces, Beijing 100027, China |
|
|
Abstract Objective To evaluate the efficacy and the application value of TACE combined with CT guided percutaneous radiofrequency ablation in the treatment of large hepatocellular carcinoma. Methods A retrospective analysis was made on clinical data of 52 patients proved by pathology and imaging diagnosis of hepatocellular carcinoma. All the patients received one TACE treatment, and were reexamined by contrast-enhanced CT two weeks thereafter. Then radiofrequency ablation was performed on the region lacking lipiodol deposition under CT guidance. Postoperatively, all the patients were reexamined by alpha fetoprotein, contrast-enhanced MRI or CT to evaluate the volume reduction and necrosis of tumors and were followed up for 12 months. Results The operations on all 52 patients (56 lesions) were successful without serious complications. The volumes of tumors decreased to varying degrees compared with the preoperative ones. The maximum of the diameters of the focuses was (12.7±2.7) cm before TACE, and the maximum of the diameters of the focuses was (6.1±1.9) cm after the RF ablation operations (t=14.416, P<0.05). The AFP values decreased significantly, with the AFP value before TACE being (4156±689) ng/ml and the AFP value after the RF ablation operations being (256±178) ng/ml (t=39.485, P<0.05). Complete ablation (CR) was found in 26 cases, ablation in the majority (PR) was found in 21 cases, 4 cases were found to be stable (SD), progress (PD) was found in 1 case, and the total effective rate was 90.4%. The 12 months survival rate was 92.3%. Conclusions TACE combined with CT guided percutaneous radiofrequency ablation is safe, effective and minimally invasive in the treatment of large hepatocellular carcinoma.
|
Received: 05 November 2014
|
|
|
|
|
[1] |
杨广顺,吴孟超,吴志全.原发性肝癌的规范化综合治疗[J].中华外科杂志,2001,39(10):742-744.
|
[2] |
李家开,张 晶,于 淼, 等. 同轴微导管肝动脉化疗栓塞联合射频消融治疗原发性肝癌 [J].介入放射学杂志,2009,18(5):331-334.
|
[3] |
吴沛宏, 张福君, 赵 明, 等. 肝动脉栓塞化疗联合CT导向射频消融术治疗中、晚期肝癌的评价[J]. 中华放射学杂志, 2003, 37(10): 901-904.
|
[4] |
郑加生,李建军.肝动脉化疗栓塞联合CT引导下射频消融术治疗肝癌的疗效分析[J].介入放射学杂志,2009,18(5):324-327.
|
[5] |
朱 彤,沈 英,范 俊,等.经皮肝穿刺射频热凝治疗原发性小肝癌[J].中国普通外科杂志,2002,11(9):522- 524.
|
[6] |
杨秉辉. 原发性肝癌的临床诊断与分期标准[J]. 中华肝脏病杂志, 2001, 9(6): 324-324.
|
[7] |
王 华,王颖超,厚瑞萍,等.TACE联合RFA治疗原发性肝癌的临床疗效[J].山东医药,2013,53(29):52-54.
|
[8] |
郑志勇.TACE联合射频消融治疗肝癌的临床疗效[J].河北医学, 2014, 20(6): 52-54.
|
[9] |
齐 璇.射频消融治疗子宫肌瘤的疗效及其安全性[J].武警医学, 2013,23(8):652-654.
|
[10] |
陈敏山,李锦清,梁惠宏,等.经皮消融与手术切除治疗小肝癌的疗效比较[J].中华医学杂志,2005,85(2):80-83.
|
[11] |
韩聚强,范公忍,任永强,等.不同微创介入治疗原发性肝癌对机体T细胞免疫功能的影响[J].介入放射学杂志,2014,23(3):218-221.
|
[12] |
蔡 凯,张 闯,江 涛.肿瘤射频消融治疗后的免疫反应及抗肿瘤效应 [J].国际肿瘤学杂志,2014,40(11):826-829.
|
[13] |
俞 渊.肝动脉栓塞化疗联合射频消融、门静脉化疗治疗对原发性肝癌患者免疫状态的研究[J].检验医学与临床,2014,10(16):2130-2132.
|
|
|
|