摘要
目的比较经动脉化疗栓塞(TACE)同步联合微波消融(MWA)与TACE序贯联合MWA治疗肝细胞癌(HCC)的有效性与安全性。方法回顾性分析苏州大学附属第一医院单中心2016年2月至2021年3月间行TACE同步或序贯联合MWA治疗的HCC患者临床资料。主要观察指标为无进展生存(PFS)时间和3、6及12个月总体生存(OS)率,次要观察指标为消融针次、消融时间、肿瘤反应及并发症发生率。结果共63例患者纳入本研究,同步组29例,序贯联合组34例。两组患者的PFS时间[同步组(7.4±2.4)个月vs序贯组(6.2±3.6)个月],3、6、12个月OS率(同步组100%、100%、96.6%vs序贯组100%、97.1%、91.2%),差异均无统计学意义(P>0.05)。同步组平均消融针次[(1.5±0.5)次]及消融时间[(9.9±3.9)min]均低于序贯组[(2.1±0.7)次、(14.6±4.5)min],均存在统计学差异(P<0.05)。两组患者肿瘤客观反应率(同步组79.4%vs序贯组73.5%)和肿瘤控制率(同步组89.7%vs序贯组88.2%)无统计学差异(P>0.05)。两组患者不良反应及并发症发生率无统计学差异(P>0.05)。结论本研究初步结果显示TACE同步联合或序贯联合MWA两种方式均能有效控制HCC肿瘤进展,在近期疗效方面无差异。与序贯联合相比,TACE同步联合MWA治疗能减少消融针次及消融时间,且未增加并发症发生率。
Objective To compare the efficacy and safety of transarterial chemoembolization(TACE)synchronously or sequentially combined with microwave ablation(MWA)in patients with hepatocellular carcinoma(HCC).Methods A retrospective analysis was carried out on clinical data of HCC patients treated with TACE synchronously or sequentially combined with MWA,from a single center,the First Affiliated Hospital of Soochow University,between Feb.2016 and Mar.2021.The primary outcome measures were progression-free survival(PFS)time,and 3-,6-,and 12-month overall survival(OS)rate;the secondary outcome measures were ablation needle times,ablation duration,tumor response,and complication incidence rate.Results A total of 63 HCC patients were enrolled in this study,29 in synchronous group and 34 in sequential group.No statistically significant difference was observed between the two groups in terms of PFS time[synchronous group(7.4±2.4)months vs sequential group(6.2±3.6)months,P>0.05],the 3-,6-,12-month OS rates(synchronous group 100%,100%,96.6%vs sequential group 100%,97.1%,91.2%),all P>0.05.The average ablation needle times and ablation duration in the synchronous group[(1.5±0.5)times and(9.9±3.9)min,respectively]were lower than those in the sequential group[(2.1±0.7)times and(14.6±4.5)min,respectively],with statistical significant difference(P<0.05).There was no significant difference in tumor objective response rate(synchronous group 79.4%vs sequential group 73.5%),tumor control rate(synchronous group 89.7%vs sequential group 88.2%)or incidences of adverse reactions and complications between the two groups(P>0.05).Conclusion This preliminary study showes that both TACE synchronously and sequentially combined with MWA can effectively control tumor progression in HCC,and there was no significant difference in short-term efficacy.But TACE synchronously combined with MWA can further reduce the ablation needle times and ablation duration,with no increased complications incidence.
作者
刘鹏辉
仲斌演
张帅
李婉慈
沈建
朱晓黎
LIU Penghui;ZHONG Binyan;ZHANG Shuai;LI Wanci;SHEN Jian;ZHU Xiaoli(Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)
出处
《肝胆胰外科杂志》
CAS
2023年第4期213-218,共6页
Journal of Hepatopancreatobiliary Surgery
关键词
肝细胞癌
经动脉化疗栓塞
微波消融
联合治疗
同步治疗
序贯治疗
hepatocellular carcinoma
transarterial chemoembolization
microwave ablation
combined therapy
synchronous therapy
sequential therapy
