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目的探讨经皮微波和射频消融治疗肝癌临床效果的差异。方法以相同的纳入标准,回顾性比较了肝细胞性肝癌经超声引导经皮微波消融49例98个结节和射频消融53例72结节的局部疗效、并发症和远期生存率。结果微波组与射频组比较,肿瘤完全消融率分别为94.9%(93/98)和93.1%(67/72)(P=0.75),局部复发率为11.8%(11/93)和20.9%(14/67)(P=0.12)。主要并发症发生率分别为8.2%(4/49)和5.7%(3/53)(P=0.71)。1、2、3年无瘤生存率微波组分别为45.9%、26.9%和26.9%,射频组为37.2%、20.7%和15.5%(P=0.53)。1、2、3、4年累积生存率微波组分别为81.6%、61.2%、50.5%和36.8%,射频组为71.7%、47.2%、37.6%和24.2%(P= 0.12)。结论经皮微波和射频消融治疗肝癌的局部疗效、并发症和远期生存率无显著差别,均为安全有效的肝癌治疗手段。
Objective To investigate the clinical effects of percutaneous microwave radiofrequency ablation (RFA) in the treatment of liver cancer. Methods The same inclusion criteria were compared retrospectively for the local curative effect, complication and long-term survival rate of 49 cases with 98 nodules and 53 cases with 72 nodules treated by ultrasound-guided percutaneous microwave ablation. Results The complete tumor ablation rates of microwave group were 94.9% (93/98) and 93.1% (67/72) respectively (P = 0.75), and the local recurrence rates were 11.8% (11/93) and 20.9% 14/67) (P = 0.12). The major complication rates were 8.2% (4/49) and 5.7% (3/53), respectively (P = 0.71). The tumor-free survival rates at 1, 2 and 3 years were 45.9%, 26.9% and 26.9% in the microwave group and 37.2%, 20.7% and 15.5% in the radiofrequency group (P = 0.53). The cumulative survival rates at 1, 2, 3, and 4 years were 81.6%, 61.2%, 50.5% and 36.8% in the microwave group and 71.7%, 47.2%, 37.6% and 24.2% in the radiofrequency group (P = 0.12). Conclusion The local curative effect, complications and long-term survival rate of percutaneous microwave radiofrequency ablation and radiofrequency ablation are not significantly different, which are safe and effective treatment of liver cancer.