CAJ | 학술논문

目的探讨经皮射频消融(RFA)联合经皮肝动脉插管化疗栓塞(TACE)治疗原发性肝癌的临床疗效.方法将确诊的62例原发性肝癌患者(肿瘤最大直径3 ～5 cm)随机分为RFA联合TACE组(联合组)和单纯RFA组(射频组).其中联合组患者先行TACE治疗,1周后再行RFA治疗;射频组患者直接行RFA治疗.随访时间9～ 39个月,采用Kaplan-Meier方法进行生存分析,Logrank检验比较生存曲线差异.结果联合组患者的1、2、3年总生存率分别为90.6％、72.0％和53.1％,单纯射频组患者的1、2、3年总生存率分别为86.6％、63.3％和40.0％,差异无统计学意义(P =0.176).联合组患者的1、2、3年无瘤生存率分别为75.0％、50.0％和34.3％,单纯射频组患者的1、2、3年无瘤生存率分别为63.3％、33.3％、16.7％,差异有统计学意义(P =0.027).联合组患者的1、2、3年局部肿瘤进展率分别为12.5％、18.8％和18.8％,单纯射频组患者的1、2、3年局部肿瘤进展率分别为16.7％、30.0％和36.6％,差异有统计学意义(P =0.047).结论对于最大直径为3～5 cm的原发性肝癌患者,RFA联合TACE的疗效优于单纯RFA.
목적 탐토경피사빈소융(RFA)연합경피간동맥삽관화료전새(TACE)치료원발성간암적림상료효.방법 장학진적62례원발성간암환자(종류최대직경3 ～5 cm)수궤분위RFA연합TACE조(연합조)화단순RFA조(사빈조).기중연합조환자선행TACE치료,1주후재행RFA치료;사빈조환자직접행RFA치료.수방시간9～ 39개월,채용Kaplan-Meier방법진행생존분석,Logrank검험비교생존곡선차이.결과 연합조환자적1、2、3년총생존솔분별위90.6％、72.0％화53.1％,단순사빈조환자적1、2、3년총생존솔분별위86.6％、63.3％화40.0％,차이무통계학의의(P =0.176).연합조환자적1、2、3년무류생존솔분별위75.0％、50.0％화34.3％,단순사빈조환자적1、2、3년무류생존솔분별위63.3％、33.3％、16.7％,차이유통계학의의(P =0.027).연합조환자적1、2、3년국부종류진전솔분별위12.5％、18.8％화18.8％,단순사빈조환자적1、2、3년국부종류진전솔분별위16.7％、30.0％화36.6％,차이유통계학의의(P =0.047).결론 대우최대직경위3～5 cm적원발성간암환자,RFA연합TACE적료효우우단순RFA.
Objective To compare the effect of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) with radiofrequency ablation alone for the treatment of 3-5 cm hepatocellular carcinoma (HCC).Methods From January 2006 to March 2010,sixty-two HCC patients were randomly treated with RFA combined with TACE (n =32) or RFA alone (n =30).This group included the patients who had Child-Pugh class A or B with three or fewer tumors,in which just one tumor size was 3-5 cm in diameter,and no evidence of extrahepatic tumor metastasis or macrovascular invasion.The follow up ranged from 9 to 39 months.Survival probabilities were estimated with the Kaplan-Meier method,and differences between survival curves were evaluated with the Log rank test.Results At the end of the study,the 1-,2-and 3-year overall survival rates in the combined treatment group were 90.6％,72％,and 53.1％,respectively,and in the radiofrequency ablation alone group were 83.3％,56.75％,and 23.3％,respectively.The differences between the survival curves of the two groups were not statistically significant (P =0.176).The 1-,2-,and 3-year progress-free survival rates in the combined treatment group were 75.0％,50.0％,and 34.3％,respectively,and in the radiofrequency ablation alone group were 63.3％,33.3％,and 16.7％,respectively.The differences between the two groups were statistically significant (P=0.027).The 1-,2-,and 3-year local tumor progression rates in the combined treatment group were 12.5％,18.75％,and 18.75％ vs.16.7％,30％,and 36.6％ in the radiofrequency ablation alone group,with a significant difference between the two groups (P =0.047).Conclusion Radiofrequency ablation plus TACE is better than radiofrequency ablation alone for the treatment of 3-5 cm hepatocellular carcinoma.