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目的研究经皮射频消融联合伽玛刀(RFA-γ刀)治疗5cm以下原发性肝癌的疗效。方法随机应用RFA-γ刀和单纯RFA分别治疗≤5cm,单发病灶原发性肝癌39例和45例,以总生存率和复发转移率作为评价指标,比较两种方法的疗效。结果 RFA-γ刀组和单纯RFA组的1、2、3年总生存率分别为97.4%、89.7%、76.9%和95.6%、84.4%、68.9%(P﹥0.05);1、2、3年复发转移率分别为5.1%、17.9%、28.2%和8.8%、26.7%、42.2%,其中1、2、3年局部复发率分别为0%、2.6%、5.1%和4.4%、11.1%、20%(P﹤0.05)。结论对于≤5cm原发性肝癌,RFA-γ刀治疗可以提高RFA疗效,减低复发转移率,从而提高远期生存,是一种较好的综合治疗方法。
Objective To investigate the efficacy of percutaneous radiofrequency ablation combined with gamma knife (RFA-γ knife) in the treatment of primary hepatic carcinoma less than 5 cm. Methods Randomly treated with RFA-γ knife and RFA alone ≤5cm, single-tumor primary liver cancer in 39 cases and 45 cases, the overall survival rate and recurrence and metastasis rate as an evaluation index, the efficacy of the two methods. Results The 1, 2, 3 year overall survival rates of RFA-γ group and RFA group were 97.4%, 89.7%, 76.9% and 95.6%, 84.4% and 68.9% respectively (P> 0.05) The annual recurrence and metastasis rates were 5.1%, 17.9%, 28.2%, 8.8%, 26.7% and 42.2% respectively. The local recurrence rates at 1, 2 and 3 years were 0%, 2.6%, 5.1% and 4.4% , 20% (P <0.05). Conclusion For ≤5cm primary liver cancer, RFA-γ knife treatment can improve the efficacy of RFA, reduce the recurrence and metastasis rate, thereby enhancing long-term survival, is a better comprehensive treatment.