文章：

经动脉化疗栓塞联合射频消融治疗超声引导下经皮射频消融不可行的肝细胞癌：与常规超声引导下射频消融疗效的比较研究

Combined Transarterial Chemoembolization and Radiofrequency Ablation for Hepatocellular Carcinoma Infeasible for Ultrasound-Guided Percutaneous Radiofrequency Ablation: A Comparative Study with General Ultrasound-Guided Radiofrequency Ablation Outcomes

原文发布日期：28 October 2023

DOI: 10.3390/cancers15215193

类型: Article

开放获取: 是

英文摘要：

Objectives: This study aimed to evaluate the therapeutic outcomes of transarterial chemoembolization combined with radiofrequency ablation (TACE + RFA) for hepatocellular carcinomas (HCC) measuring ≤3 cm infeasible for ultrasound (US)-guided percutaneous RFA. Methods: Twenty-four patients who underwent fluoroscopy-guided TACE + RFA for single HCC between January 2012 and December 2016 were screened. To evaluate the TACE + RFA outcomes compared with those of US-guided RFA, 371 patients who underwent US-guided RFA during the same period were screened. We compared local tumor progression (LTP) and intrahepatic distant recurrence (IDR) between the two groups before and after propensity score (PS) matching, and performed univariable and multivariable Cox proportional hazard regression analyses for all patients. Results: PS matching yielded 21 and 42 patients in the TACE + RFA and US-guided RFA groups, respectively. Cumulative LTP rates after PS matching were not significantly different between the two groups at 1 (0.0% vs. 7.4%,p= 0.072), 2 (10.5% vs. 7.4%,p= 0.701), and 5 years (16.9% vs. 10.5%,p= 0.531). IDR rates did not differ significantly between the two groups at 1 (20.6% vs. 10%,p= 0.307), 2 (25.9% vs. 25.9%,p= 0.999), or 5 years (49.9% vs. 53%,p= 0.838). Multivariable analysis showed that treatment type was not a significant factor for LTP or IDR. Conclusion: The outcomes of TACE + RFA for HCC were similar to those of general US-guided RFA. Fluoroscopy-guided TACE + RFA may be an effective treatment when US-guided RFA is not feasible.

摘要翻译： 

目的：本研究旨在评估经动脉化疗栓塞联合射频消融（TACE + RFA）治疗因技术原因无法行超声引导经皮射频消融、直径≤3 cm的肝细胞癌（HCC）的疗效。方法：筛选2012年1月至2016年12月期间接受透视引导下TACE + RFA治疗的单发HCC患者24例。为与超声引导RFA的疗效进行对比，同期筛选接受超声引导RFA治疗的患者371例。比较两组在倾向评分匹配前后的局部肿瘤进展（LTP）和肝内远处复发（IDR）情况，并对所有患者进行单变量和多变量Cox比例风险回归分析。结果：倾向评分匹配后，TACE + RFA组和超声引导RFA组分别纳入21例和42例患者。匹配后两组累积LTP率在1年（0.0% vs. 7.4%，p=0.072）、2年（10.5% vs. 7.4%，p=0.701）和5年（16.9% vs. 10.5%，p=0.531）均无显著差异。IDR率在1年（20.6% vs. 10%，p=0.307）、2年（25.9% vs. 25.9%，p=0.999）和5年（49.9% vs. 53%，p=0.838）亦无显著差异。多变量分析显示治疗类型并非影响LTP或IDR的显著因素。结论：TACE + RFA治疗HCC的疗效与常规超声引导RFA相似。当超声引导RFA不可行时，透视引导下TACE + RFA可能是一种有效的治疗选择。

原文链接：

Combined Transarterial Chemoembolization and Radiofrequency Ablation for Hepatocellular Carcinoma Infeasible for Ultrasound-Guided Percutaneous Radiofrequency Ablation: A Comparative Study with General Ultrasound-Guided Radiofrequency Ablation Outcomes