Microwave versus Radiofrequency Ablation Treatment for Hepatocellular Carcinoma: A Comparison of Efficacy at a Single Center.
Microwave versus Radiofrequency Ablation Treatment for Hepatocellular Carcinoma: A Comparison of Efficacy at a Single Center.
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DOI：
10.1016/j.jvir.2016.01.136
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Lee FT Jr
中科院分区：
文献类型：
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作者：
Potretzke TA;Ziemlewicz TJ;Hinshaw JL;Lubner MG;Wells SA;Brace CL;Agarwal P;Lee FT Jr
比较射频（RF）与微波（MW）消融治疗肝细胞癌（HCC）的疗效及主要并发症发生率。本回顾性研究纳入了2001年至2013年间55例射频治疗患者中的69个肿瘤和99例MW治疗患者中的136个肿瘤。所有肿瘤均经标准影像学诊断为HCC。射频和毫瓦烧蚀装置都包括17号口径的直涂器。使用Kaplan-Meier技术和Cox比例风险模型评估总生存率和局部肿瘤进展率，以及局部肿瘤进展的竞争风险回归。RF组和MW组在年龄（平均：62岁[范围23-88]和61岁[44-82]岁，p=0.22）、MELD（分别为8.8和9.6岁，p=0.24）和肿瘤大小（分别为2.4 [0.6-4.5]cm和2.2 [0.5-4.2]cm, p=0.09）方面相似。RF的中位随访时间为31个月，MW的中位随访时间为24个月。RF组局部肿瘤进展率为17.7%，MW组为8.8%。Cox和竞争风险模型对应的HR分别为2.17 [95% CI: 1.04-4.50] （p=0.04）和2.01 [0.95-4.26]（p=0.07）。虽然没有统计学意义（Cox风险比1.59 [0.91-2.77];p=0.103），但接受MW治疗的患者的生存率有所提高。两组的主要（≥C级）并发症都很少（RF 2例，MW 1例；p=0.28）。在这项单中心试验中，经皮射频或毫瓦消融治疗HCC具有较高的原发性疗效和持久的反应，毫瓦消融后局部肿瘤进展率较低。
To compare the efficacy and major complication rate of radiofrequency (RF) and microwave (MW) ablation for the treatment of hepatocellular carcinoma (HCC). This retrospective study included 69 tumors in 55 patients treated by RF, and 136 tumors in 99 patients treated by MW between 2001 and 2013. All tumors were diagnosed as HCC by standard imaging criteria. Both RF and MW ablation devices comprised straight 17-gauge applicators. Overall survival and rates of local tumor progression were evaluated using Kaplan-Meier techniques with Cox proportional hazard models, as well as competing risk regression of local tumor progression. RF and MW cohorts were similar in age (mean: 62 [range 23-88] and 61 [44-82] yr, respectively; p=0.22), MELD (8.8 and 9.6, respectively; p=0.24), and tumor size (2.4 [0.6-4.5] cm and 2.2 [0.5-4.2] cm, respectively; p=0.09). Median length of follow-up was 31 months for RF and 24 months for MW. The rate of local tumor progression was 17.7% with RF and 8.8% with MW. The corresponding HR from Cox and competing risk models were 2.17 [95% CI: 1.04-4.50] (p=0.04) and 2.01 [0.95-4.26] (p=0.07), respectively. There was improved survival for patients treated with MW, although this was not statistically significant (Cox HR 1.59 [0.91-2.77]; p=0.103). There were few major (≥ grade C) complications in either group (2 for RF, 1 for MW; p=0.28). In this single center trial, treating HCC percutaneously with RF or MW ablation was associated with high primary efficacy and a durable response, with lower rates of local tumor progression noted after MW ablation.