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目的探讨经肝动脉栓塞化疗(TACE)后联合射频消融(RFA)治疗大肝癌的效果。方法笔者在2002年5月至2005年5月期间,将58例大肝癌(直径≥5.0 cm)病人根据治疗方式的不同分为3组,分别为:RFA组(n=18),TACE+RFA组(n=19),TACE组(n=21);其中TACE+ RFA组先行TACE 1次,7～10 d后再行RFA治疗;其余两组为对照组,其中RFA组单纯使用RFA治疗。结果58例病人经3年以上的随访,TACE+RFA组1、2、3年存活率分别为:84.2%、42.1%、36.8%;RFA组1、2、3年存活率分别为:61.1%、22.2%、16.7%;TACE组1、2、3年存活率分别为:57.1%、28.5%、14.3%;发现TACE+RFA组的1、2、3年存活率比其它两组明显延长(P<0.01)。结论TACE联合RFA是治疗大肝癌的一种较好的治疗方法,可提高大肝癌的治疗疗效。
Objective To investigate the effect of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) in the treatment of large hepatocellular carcinoma (HCC). Methods From May 2002 to May 2005, 58 patients with large hepatocellular carcinoma (diameter≥5.0 cm) were divided into three groups according to the different treatment methods: RFA group (n = 18), TACE + RFA (N = 19) and TACE group (n = 21). TACE was performed once in TACE + RFA group and 7 to 10 days before RFA treatment. The other two groups were control group. RFA group was treated with RFA alone. Results Survival rates at 1, 2 and 3 years in TACE + RFA group were 84.2%, 42.1% and 36.8% respectively after 58 years of follow-up of more than 3 years. The survival rates at 1, 2 and 3 years in RFA group were 61.1% , 22.2% and 16.7%, respectively. The survival rates at 1, 2 and 3 years in TACE group were 57.1%, 28.5% and 14.3%, respectively. The survival rates at 1, 2 and 3 years in TACE + RFA group were significantly longer than those in other two groups P <0.01). Conclusion TACE combined with RFA is a better treatment of large hepatocellular carcinoma, which can improve the therapeutic effect of large hepatocellular carcinoma.