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    肝动脉化疗栓塞联合微波消融术治疗早中期肝癌疗效分析

    Efficacy analysis of TACE combined with MWA in the treatment of early and middle hepatocellular carcinoma

      摘要
    • 摘要:
      目的探讨早中期肝癌经肝动脉化疗栓塞（TACE）联合经皮微波消融术（MWA）序贯治疗的临床疗效。
      方法回顾性分析行TACE（TACE组）及TACE序贯MWA（TACE+MWA组）治疗的病人共108例临床资料，2组病人1∶1进行倾向性匹配，最终各纳入26例。分析2组短期疗效及长期疗效，并按照肿瘤大小及肿瘤数量进行亚组分析。
      结果TACE+MWA组和TACE组中位生存时间分别为28个月及13个月，1、2、3年生存率分别为84.6%、59.0%、35.2%及57.7%、30.3%、19.5%，TACE+MWA组生存率优于TACE组（P < 0.01）。TACE+MWA组及TACE组的短期疗效客观有效率分别为61.5%、30.8%（P < 0.05），疾病控制率分别为80.8%、46.2%，差异均有统计学意义（P < 0.05）。TACE+MWA组在肿瘤大小 < 5 cm及病灶数量2~4枚时获益较TACE组更大（P < 0.05）。
      结论TACE序贯MWA治疗可有效提高早中期肝癌生存率，延长生存时间。

       

      Abstract:
      ObjectiveTo explore the clinical value of the sequential treatment of transcatheter arterial chemoembolization(TACE) combined with percutaneous microwave ablation(MWA) in early and middle hepatocellular carcinoma.
      MethodsThe clinical data of 108 patients treated with TACE alone or TACE combined with MWA were retrospectively analyzed.The propensity matching was performed at 1:1 in two groups, and 26 patients were included in each group.The short and long-term clinical efficacy in two groups were evaluated, and the subgroup analysis was also conducted based on tumor size and lesions.
      ResultsThe median survival time in TACE group and TACE-MWA group were 13 and 28 months, respectively.The survival rates of 1, 2 and 3 years in TACE-MWA group and TACE group were(84.6%, 59.0% and 35.2%, respectively) and(57.7%, 30.3% and 19.5%, respectively), and the survival rate in TACE-MWA group was better than that in TACE group(P < 0.01).The short-term efficacy in TACE-MWA group(61.5%) was higher than that in TACE group(30.8%)(P < 0.05).The disease control rate in TACE-MWA and TACE group was 80.8% and 46.2%, respectively, and the difference of which was statistically significant(P < 0.05).When the tumor size was < 5 cm, and the number of lesions was 2-4, the benefit in TACE+MWA group was greater than that in TACE group(P < 0.05).
      ConclusionsThe TACE with MWA sequential treatment can effectively improve the survival rate, and prolong the survival time in early and middle hepatocellular carcinoma patients.

       

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