Therapeutic effects and prognostic factors in high-intensity focused ultrasound combined with chemoembolisation for larger hepatocellular carcinoma
Therapeutic effects and prognostic factors in high-intensity focused ultrasound combined with chemoembolisation for larger hepatocellular carcinoma
复制标题
DOI：
10.1016/j.ejca.2010.06.015
复制
发表时间：
2010-09-01
影响因子：
8.4
通讯作者：
Zhang, Fujun
中科院分区：
文献类型：
--
作者：
Li, Chuanxing;Zhang, Weidong;Zhang, Fujun
本研究的目的是评价高强度聚焦超声（HIFU）消融联合经导管动脉化疗栓塞（TACE）治疗较大肝癌（HCC）的疗效。将89例不值得注意的较大HCC患者随机分配至TACE组（n = 45）和TACE + HIFU组（n = 44）。随访时通过体格检查、血清甲胎蛋白水平、计算机断层扫描或磁共振成像评估治疗效果。所有患者均随访观察远期疗效并评估影响生存的预后因素。无严重并发症发生。随访图像显示，TACE-HIFU组肿瘤缓解总有效率为72.8%，明显高于TACE组（44.5%，P < 0.05）。TACE-HIFU组1、2、3、5年生存率分别为72.7%、50.0%、31.8%、11.4%，TACE组1、2、3、5年生存率分别为47.2%、16.7%、2.8%、0%（P < 0.01）。TACE-HIFU组1、2、3、5年无瘤生存率分别为34.1%、18.2%、9.1%、0%，TACE组1、2、3、5年无瘤生存率分别为13.9%、5.6%、0%、0%（P < 0.01）。TNM分期、门静脉癌栓和Child-Pugh分级对生存率均有显著影响。高强度聚焦超声消融联合肝动脉化疗栓塞是安全、有效的，是治疗较大肝癌的一种有前途的方法。(C)2010爱思唯尔有限公司版权所有。
The purpose of this study is to evaluate high-intensity focused ultrasound (HIFU) ablation combined with transcatheter arterial chemoembolisation (TACE) in the treatment of larger hepatocellular carcinoma (HCC). Eighty-nine (89) patients with unrespectable larger HCC were randomised into a TACE group (n = 45) and a TACE plus HIFU group (n = 44). Therapeutic effects were assessed at follow-up with physical examination, level of serum alpha-fetoprotein and computed tomography or magnetic resonance imaging. All patients were followed up to observe long-term therapeutic effects and evaluated prognostic factors for survival. No severe complication was observed. Follow-up images showed that total effective rate in tumour response accounted for 72.8% in the TACE-HIFU group, which were significantly higher than that of TACE group (44.5%, P < 0.05). The 1-, 2-, 3- and 5-year overall survival rates for the TACE-HIFU group were 72.7%, 50.0%, 31.8% and 11.4%, respectively; correspondingly, for the TACE group were 47.2%, 16.7%, 2.8% and 0%, respectively (P < 0.01). The 1-, 2-, 3- and 5-year disease-free survival rates for the TACE-HIFU group were 34.1%, 18.2%, 9.1% and 0%, respectively; correspondingly, for the TACE group were 13.9%, 5.6%, 0% and 0%, respectively (P < 0.01). TNM stage, portal vein tumour thrombosis and Child-Pugh classification each had a significant effect on the survival. HIFU ablation combined with TACE is safe, effective and a promising approach for the treatment of larger HCC. (C) 2010 Elsevier Ltd. All rights reserved.