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

来源 :中国微创外科杂志 | 被引量 : 0次 | 上传用户:jquerystu
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
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。 Objective To investigate the therapeutic effect of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) on hepatocellular carcinoma (HCC)> 5 cm in diameter. Methods Thirty patients with HCC> 5 cm in diameter from January 2007 to January 2014 were retrospectively analyzed. Their ages ranged from 34 to 83 years (58.4 ± 12.7 years). Intrahepatic tumors were single, diameter 5 ~ 17 cm, (7.0 ± 2.6) cm. Liver function Child-Pugh score A grade 19 cases, B grade 11 cases. The patient’s Karnofsky performance status (KPS) score was 70-100 (88.6 ± 10.3). Treatment sequence: first TACE treatment, timely delivery of RFA after TACE. Follow-up process if found in the tumor remains or relapse, TACE is still in line with RFA treatment. The end of follow-up event was the patient’s death or the end of the follow-up period (January 2014). Survival analysis was performed using Kaplan-Meier method and the Child-Pugh and KPS scores of surviving patients survived at the end of follow-up were compared before and after treatment. Results After TACE and RFA combined treatment, 23 cases (76.7%) were completely inactivated in 30 cases and 7 cases (23.3%) were not completely inactivated. In the follow-up period, 24 cases (80%) showed new intrahepatic lesions, and 6 cases (20%) showed no new lesions. Nine patients (30%) had complete remission (CR), one patient (3.3%) had partial remission (PR), seven patients (23.3%) had progression of disease (PD) Thirteen patients died (43.3%). There was no significant difference in Child-Pugh score and KPS score between survivors and follow-up (P> 0.05). The whole group was followed up for 13 to 60 months (34.1 ± 14.1) months. The median survival was 48 months (95% CI, 34 to 62 months). The 1, 3, 5 year survival rates were 96.7%, 69.5% and 33.2% respectively. Conclusions This study further confirmed that TACE combined with RFA was safe and effective, which could control the progress of intrahepatic lesions in HCC patients and improve their quality of life. The data of survival were satisfactory. TACE in combination with RFA is an effective treatment for HCC patients> 5 cm in diameter.
其他文献
量恒式干选机干式预选工艺与高压辊磨风力磁选工艺应用于铁矿石的生产,在破碎段实现了大规模预先干式抛尾矿,大幅提高了入磨矿品位,减少入磨矿数量,使磁铁矿细颗粒物料实现了
为简化变迹叉指换能器设计过程,提出了一种新的变迹叉指换能器的设计方法,它以叉指换能器的中心频率处的插入损耗和旁瓣电平作为寻优目标,叉指换能器的指条长度作为基因,通过
教育心理学是高等教育必修课之一,是培养合格师资的一门重要课程,也是教育学、专业学科教育课程的基础.学习心理学对于了解人的心理发生发展规律,尤其是如何针对学生的心理特
目的探讨单操作孔全胸腔镜手术治疗小儿后纵隔肿瘤的疗效。方法 2011年1月~2014年12月对36例患儿行单操作孔全胸腔镜下后纵隔肿瘤切除术,患侧卧位,腋中线第7~8肋间做腔镜孔,
在集抄系统建设中,极易出现485线接线异常,为避免设备安装返工次数,实现异常快速检测,设计便携式电表箱485接线快速检测装置.设计便携式电表箱485接线快速检测装置,以营销掌
颅脑创伤的发病率和致残率一直居高不下,目前尚无有效的治疗手段.大多数治疗都旨在改善二次损伤引发的损害[1].自发现神经干细胞(NSCs)以来,国内外研究者对NSCs治疗颅脑创伤
为解决野外施工现场数据采集系统中数据传输问题 ,对数据采集系统中闪速固态盘系统进行了研制。固态盘系统采用 ATMEL公司的 AT89C5 1微控制器 ,选用闪速存储器 (Flash Memor
移动互联网已经改变人们生活,提供了更多的方便,同时人们功能需求也增加.目前APP开发有原生技术开发和Html5技术开发,文章采用Html5技术进行APP插件开发.通过UML用例技术进行
肠内营养是危重症患者最常见的营养方式.单纯的鼻胃管营养容易发生反流和误吸,引发肺部感染,不利于肠内营养支持的实施.螺旋型鼻肠管为聚氨酯管道,生物相容性好,对机体无明显