Combined ultrasound/computed tomography guidance in percutaneous radiofrequency ablation after transarterial chemoembolization for hepatocellular carcinoma in the hepatic dome
Combined ultrasound/computed tomography guidance in percutaneous radiofrequency ablation after transarterial chemoembolization for hepatocellular carcinoma in the hepatic dome
复制标题
超声/CT联合引导肝顶肝细胞癌经动脉化疗栓塞术后经皮射频消融术
DOI：
10.2147/cmar.s212127
复制
发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Zheng, Chuansheng
中科院分区：
文献类型：
--
作者：
Kan, Xuefeng;Wang, Yong;Zheng, Chuansheng
目的 评价超声（US）/计算机断层扫描（CT）联合引导（首先采用US引导将电极针穿刺至靠近肿瘤部位，随后采用CT引导精确定位电极头）在肝顶肝细胞癌（HCC）经动脉化疗栓塞（TACE）后经皮射频消融（RFA）中的应用价值。方法 回顾性分析2013年1月1日至2017年6月30日65例在RFA术前接受TACE治疗的肝穹HCC患者的病历。其中，34例患者35个肝脏肿瘤在US/CT联合引导下接受经皮RFA，31例患者35个肝脏肿瘤在CT单独引导下接受经皮RFA。分析US/CT引导下联合RFA的疗效，并比较两组的手术时间和安全性。结果 US/CT引导下联合RFA组的1、3、5年局部复发率分别为3%、6%、9%，1、3、5年总生存率分别为100%、97%、94%。 CT引导RFA组的平均手术时间明显长于US/CT引导RFA联合组（P<0.001）。虽然两组总体并发症发生率无统计学意义，但超声/CT引导RFA联合组未出现RFA相关并发症。 CT引导RFA组术后右上腹疼痛不良反应发生率高于US/CT引导RFA联合组（P=0.01）。结论 US/CT联合引导下经皮射频消融对治疗肝顶肝癌有帮助。
Purpose To assess the value of the combined ultrasound (US)/computed tomography (CT) guidance (US guidance was firstly used for puncture with the electrode needle to the site close to the tumor, and subsequently, CT guidance was used for precise positioning of the electrode tips) in percutaneous radiofrequency ablation (RFA) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in the hepatic dome. Methods From January 1, 2013 to June 30, 2017, medical records of 65 patients with HCCs in the hepatic dome who received TACE treatment before RFA procedure were retrospectively analyzed. Among them, 34 patients with 35 liver tumors underwent percutaneous RFA under combined US/CT guidance, and 31 patients with 35 liver tumors received percutaneous RFA under CT guidance alone. The efficacy of combined US/CT-guided RFA was analyzed, and the procedure time and safety between the two groups were compared. Results In the combined US/CT-guided RFA group, the 1-, 3-, and 5-year local recurrence rates were 3%, 6%, 9%, respectively, and the 1-, 3-, and 5-year overall survival rates were 100%, 97%, 94%, respectively. The mean procedure time in the CT-guided RFA group was significantly longer than that of the combined US/CT-guided RFA group (P<0.001). Although the overall complication rates between the two groups were not statistically significant, there were no occurrences of RFA-related complications in the combined US/CT-guided RFA group. The incidence of postoperative adverse reaction of right upper quadrant pain in the CT-guided RFA group was greater than that of the combined US/CT-guided RFA group (P=0.01). Conclusion Percutaneous RFA under the combined US/CT guidance was helpful for HCC in the hepatic dome.