射频消融（RFA）联合经导管动脉化疗栓塞（TACE）治疗中大型

StephenW

Radiofrequency Ablation (RFA) Combined with Transcatheter Arterial Chemoembolization (TACE) for Patients with Medium-to-Large Hepatocellular Carcinoma: A Retrospective Analysis of Long-Term Outcome
Weiwen Liu  1 , Huihong Xu  2 , Xihui Ying  1 , Dengke Zhang  1 , Linqiang Lai  1 , Linyou Wang  3 , Jianfei Tu  1 , Jiansong Ji  1
Affiliations
Affiliations

    1
    Department of Radiology, Lishui Central Hospital/Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang, Lishui, Zhejiang, China (mainland).
    2
    Department of Radiology, Qingtian County People's Hospital of Lishui City, Lishui, Zhejiang, China (mainland).
    3
    Department of Radiology, Taizhou Municipal Hospital of Zhejiang Province, Taizhou, Zhejiang, China (mainland).

    PMID: 32667906 DOI: 10.12659/MSM.923263

Abstract

BACKGROUND The aim of this study was to investigate the prognostic value of radiofrequency ablation (RFA) plus transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients with tumor size ranging from 3.0 to 10.0 cm. MATERIAL AND METHODS We retrospectively analyzed data on 201 patients with medium-to-large HCC. According to treatment procedure, the patients were divided into the TACE group (n=124) and the TACE+RFA group (n=77). We recorded data on patient safety, subcapsular hepatic hematoma, large amount of ascites, liver abscess, gallbladder injury, and local skin infection. The overall survival (OS) and progression-free survival (PFS) in the 2 groups were analyzed and compared between groups. RESULTS The median PFS was 4.00 months (3.00-5.00 months) in the TACE group and 9.13 months (6.64-11.62 months) in the TACE+RFA group (P<0.001). Median OS was 12.00 months (8.88-15.13 months) in the TACE group and 27.57 months (20.06-35.08 months) in the TACE+RFA group (P<0.001). In the TACE+RFA group, multivariate Cox regression analysis showed that tumor size ≤5 cm) (HR: 1.952, 95% CI: 1.213-3.143, P=0.006), hepatitis B (HR: 2.323, 95% CI: 1.096-4.923, P=0.028), TACE times (1 or >1) (HR: 1.867, 95% CI: 1.156-3.013, P=0.011), alpha-fetoprotein (AFP) level >200 ng/ml (HR: 2.426, 95% CI: 1.533-3.839, P<0.001), and AST level >40 U/L (HR: 1.946, 95% CI: 1.196-3.166, P=0.007) were independent prognostic factors for overall survival. CONCLUSIONS Combination therapy of TACE with RFA is a safe and effective treatment for patients with medium-to-large HCC, with the long-term beneficial effect of retarding tumor progression and improving PFS and OS.

StephenW

射频消融（RFA）联合经导管动脉化疗栓塞（TACE）治疗中大型肝细胞癌：长期结果回顾性分析
刘伟文1，徐慧红2，应喜辉1，张登科1，赖林强1，王林友3，涂建飞1，季建松1
隶属关系
隶属关系

    1个
    丽水市中心医院放射科/浙江省影像诊断和微创介入研究重点实验室，浙江丽水（大陆）
    2
    丽水市青田县人民医院放射科，浙江丽水（大陆）。
    3
    浙江省台州市医院放射科，浙江台州，中国（大陆）。

    PMID：32667906 DOI：10.12659 / MSM.923263

抽象

背景技术这项研究的目的是研究射频消融（RFA）联合经导管动脉化疗栓塞（TACE）在肿瘤大小为3.0至10.0 cm的肝细胞癌（HCC）患者中的预后价值。材料与方法我们回顾性分析了201例中大型肝癌患者的数据。根据治疗方法，将患者分为TACE组（n = 124）和TACE + RFA组（n = 77）。我们记录了有关患者安全性，囊下肝血肿，大量腹水，肝脓肿，胆囊损伤和局部皮肤感染的数据。分析并比较了两组的总生存期（OS）和无进展生存期（PFS）。结果TACE组中位PFS为4.00个月（3.00-5.00个月），TACE + RFA组中位PFS为9.13个月（6.64-11.62个月）（P <0.001）。 TACE组中位OS为12.00个月（8.88-15.13个月），TACE + RFA组中位OS为27.57个月（20.06-35.08个月）（P <0.001）。在TACE + RFA组中，多因素Cox回归分析显示肿瘤大小≤5cm）（HR：1.952，95％CI：1.213-3.143，P = 0.006），B型肝炎（HR：2.323，95％CI：1.096- 4.923，P = 0.028），TACE时间（1或> 1）（HR：1.867，95％CI：1.156-3.013，P = 0.011），α-甲胎蛋白（AFP）水平> 200 ng / ml（HR：2.426， 95％CI：1.533-3.839，P <0.001）和AST水平> 40 U / L（HR：1.946，95％CI：1.196-3.166，P = 0.007）是整体生存的独立预后因素。结论TACE与RFA联合治疗对中大型肝癌患者是一种安全有效的治疗方法，具有长期延缓肿瘤进展，改善PFS和OS的有益作用。