Medium or Large Hepatocellular Carcinoma: Sorafenib Combined with Transarterial Chemoembolization and Radiofrequency Ablation
Medium or Large Hepatocellular Carcinoma: Sorafenib Combined with Transarterial Chemoembolization and Radiofrequency Ablation
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中型或大型肝细胞癌：索拉非尼联合经动脉化疗栓塞和射频消融
DOI：
10.1148/radiol.2018172028
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发表时间：
2018-07-01
期刊：
影响因子：
19.7
通讯作者：
Chen, Junwei
中科院分区：
文献类型：
--
作者：
Zhu, Kangshun;Huang, Jingjun;Chen, Junwei
目的：探讨索拉非尼联合肝动脉化疗栓塞术联合射频消融术(以下简称S-TACE-RFA)治疗中大型(直径3.1~7.0 cm)肝细胞癌的安全性和有效性。材料与方法：回顾分析2010年1月至2014年12月连续接受S-TACE-RFA或联合TACE-RFA治疗的中大型肝癌患者的临床资料。索拉非尼于TACE后3~5d开始，TACE后1~2周行RFA。比较两组患者的治疗并发症、无复发生存期(RFS)和总生存期(OS)。结果：S组和TACE-RFA组均符合纳入标准。其中40例行S-TACE-RFA，66例行TACE-RFA。接受S-TACE-RFA治疗的患者的RFS(中位数，24.0vs10.0个月；P=0.04)和更好的OS(中位数，63.0vs36.0月，P=0.048)。在单因素和多因素分析中，S-TACE-RFA和甲胎蛋白水平是影响预后的独立因素。S-TACE-RFA组并发症发生率与TACE-RFA组相似(22.5%vs18.2%，P=.59)。结论：在中、大型肝癌患者中，S-TACE-RFA组较TACE-RFA组有更长的RFS和更好的OS。(C)RSNA，2018年
Purpose: To determine the safety and efficacy of sorafenib combined with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) (hereafter, S-TACE-RFA) in patients with medium or large (range, 3.1-7.0 cm in diameter) hepatocellular carcinoma (HCC).Materials and Methods: This retrospective study evaluated the medical records of consecutive patients with medium or large HCC who underwent S-TACE-RFA or combined TACE and RFA (hereafter, TACE-RFA) from January 2010 to December 2014. Sorafenib was started 3-5 days after TACE, and RFA was performed 1-2 weeks after TACE. Treatment complications, recurrence-free survival (RFS), and overall survival (OS) in patients who underwent S-TACE-RFA were compared with those in patients who underwent TACE-RFA.Results: Of the 174 patients who underwent S-TACE-RFA or TACE-RFA, 106 who met the eligibility criteria were included in this study. Among them, 40 underwent S-TACE-RFA and 66 underwent TACE-RFA. The patients who underwent S-TACE-RFA had longer RFS (median, 24.0 vs 10.0 months; P=.04) and better OS (median, 63.0 vs 36.0 months, P=.048) than those who underwent TACE-RFA. S-TACE-RFA and a-fetoprotein level were independent prognostic factors for survival in uni- and multivariable analyses. The rate of complications in patients who underwent S-TACE-RFA was similar to that in patients who underwent TACE-RFA (22.5% vs 18.2%, P=.59).Conclusion: S-TACE-RFA resulted in longer RFS and better OS than did TACE-RFA in patients with medium or large HCC. (c) RSNA, 2018