CAJ | 학술논문

目的：评价单独经导管肝动脉化疗栓塞术（ TACE）与TACE联合微波消融（ PMCT）两种方法治疗老年小肝癌的有效性及安全性。方法回顾性分析42例肝内病变直径为2～5 cm的老年小肝癌患者治疗资料，其中TACE组20例，TACE＋PMCT组22例，治疗后随访10～70个月，Fisher确切概率法比较两组患者计数资料的分布差异，肿瘤无进展生存期采用 Kaplan-Meier 法分析。结果42例患者均顺利完成治疗过程，TACE ＋PMCT组和TACE组分别有17例（77％，17／22）和19例（95％，19／20）出现肿瘤进展，其中TACE ＋PMCT组1、3、5年肿瘤无进展生存率分别为95％、85％、50％，TACE组1、3、5年肿瘤无进展生存率组分别为95％、70％、15％，差异具有统计学意义（ P＝0.018），所有患者均未发生严重并发症。结论 TACE ＋PMCT 治疗老年小肝癌较单独应用TACE治疗安全有效，可以更好地控制肝内病变，延长生存期。
목적：평개단독경도관간동맥화료전새술（ TACE）여TACE연합미파소융（ PMCT）량충방법치료노년소간암적유효성급안전성。방법회고성분석42례간내병변직경위2～5 cm적노년소간암환자치료자료，기중TACE조20례，TACE＋PMCT조22례，치료후수방10～70개월，Fisher학절개솔법비교량조환자계수자료적분포차이，종류무진전생존기채용 Kaplan-Meier 법분석。결과42례환자균순리완성치료과정，TACE ＋PMCT조화TACE조분별유17례（77％，17／22）화19례（95％，19／20）출현종류진전，기중TACE ＋PMCT조1、3、5년종류무진전생존솔분별위95％、85％、50％，TACE조1、3、5년종류무진전생존솔조분별위95％、70％、15％，차이구유통계학의의（ P＝0.018），소유환자균미발생엄중병발증。결론 TACE ＋PMCT 치료노년소간암교단독응용TACE치료안전유효，가이경호지공제간내병변，연장생존기。
Objective To evaluate the effectiveness and safety of transarterial chemoembolization ( TACE) combined with percutaneous microwave coagulation therapy ( PMCT ) in the treatment of small hepatocellular carcinoma in elderly patients ,compared with TACE alone .Methods The data of 42 elderly patients diagnosed small hepatocellular carcinoma with 2-5 cm in diameter of intrahepatic tumors were analyzed retrospectively .Twenty patients were treated with TACE alone , and 22 patients were treated with TACE combined PMCT .Follow up( range of 10-70 months ) was performed after treatment .Fisher exact test was used to compare the count data of the two groups .Progression free survival was calculated using the Kaplan-Meier method.Results All 42 patients completed the treatment successfully .Tumor progression was observed in17 cases(77%,17 /22)in TACE+PMCT group and 19 cases(95%,19/20)in TACE group.The one, three, five-year progression-free survival rate of TACE +PMCT group ( 95%, 85% and 50%, respectively)were significantly higher than those of TACE group (95%,70% and 15%,respectively;P=0.018 ) .No serious complication was observed in all patients .Conclusions The combination of TACE and PMCT is safe and provides better local tumor control and longer lifetime than TACE alone for the treatment of patients with small hepatocellular carcinoma .