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Abstract：
BACKGROUND: Drug-eluting beads transarterial chemoem-bolization (DEB-TACE) has the advantages of slow and steady release, high local concentration, and low incidence of adverse drug reactions compared to the traditional TACE. DEB-TACE combined with sequentially ultrasound-guided radiofrequency ablation (RFA) therapy has strong anti-cancer effects and little side effects, but there are fewer related long-term studies until now.
OBJECTIVE: To explore the outcome of DEB-TACE sequentially combined with RFA for patients with primary hepatocellular carcinoma (HCC).
METHODS: Seventy-six patients with primary HCC who underwent DEB-TACE sequentially combined with RFA were recruited. Forty patients with untreated HCC were included in Group A, and 36 patients with recurrent HCC were included in Group B. In addition, 40 patients with untreated HCC who were treated with hepatectomy were included in Group C. The serological examination, preoperative magnetic resonance imaging examination, and post-treatment computed tomography enhanced examination were performed for all patients. The efficacy was graded as complete remission (CR), partial remission (PR), stable disease and progressive disease at the 3rd, 6th, and 9th. All patients were followed up for 3 years and their overall survival (OS), disease-free survival (DFS) were assessed.
RESULTS: The efficacy of Group A and Group C was similar (P > 0.05), but the alanine aminotransferase, aspartate aminotransferase and total bilirubin of Group A were lower than those of Group C (all P < 0.05). The proportions of CR (32.5%), PR (37.5%) were slightly higher than Group A (CR: 27.5%, PR: 35%), but the difference was not statistically significant (χ 2 = 0.701, P = 0.873). No operational-related deaths occurred in Group A and Group C. The OS (97.5%, 84.7%, and 66.1%) and the DFS (75.0%, 51.7%, and 35.4%) of Group A at the 1st, 2nd, and 3rd year after treatment were similar with those of Group C (OS: 90.0%, 79.7%, and 63.8%; DFS: 80.0%, 59.7%, and 48.6%; P > 0.05). The OS rates in Group A and Group B (90%, 82.3%, and 66.4%) were similar (P > 0.05). The DFS rates in Group B (50%, 31.6%, and 17.2%) were lower than that of Group A (P = 0.013).
CONCLUSIONS: The efficacy of DEA-TACE combined with RFA for untreated HCC is similar with hepatectomy. Patients with recurrent HCC could get a longer survival time through the combined treatment.
OBJECTIVE: To explore the outcome of DEB-TACE sequentially combined with RFA for patients with primary hepatocellular carcinoma (HCC).
METHODS: Seventy-six patients with primary HCC who underwent DEB-TACE sequentially combined with RFA were recruited. Forty patients with untreated HCC were included in Group A, and 36 patients with recurrent HCC were included in Group B. In addition, 40 patients with untreated HCC who were treated with hepatectomy were included in Group C. The serological examination, preoperative magnetic resonance imaging examination, and post-treatment computed tomography enhanced examination were performed for all patients. The efficacy was graded as complete remission (CR), partial remission (PR), stable disease and progressive disease at the 3rd, 6th, and 9th. All patients were followed up for 3 years and their overall survival (OS), disease-free survival (DFS) were assessed.
RESULTS: The efficacy of Group A and Group C was similar (P > 0.05), but the alanine aminotransferase, aspartate aminotransferase and total bilirubin of Group A were lower than those of Group C (all P < 0.05). The proportions of CR (32.5%), PR (37.5%) were slightly higher than Group A (CR: 27.5%, PR: 35%), but the difference was not statistically significant (χ 2 = 0.701, P = 0.873). No operational-related deaths occurred in Group A and Group C. The OS (97.5%, 84.7%, and 66.1%) and the DFS (75.0%, 51.7%, and 35.4%) of Group A at the 1st, 2nd, and 3rd year after treatment were similar with those of Group C (OS: 90.0%, 79.7%, and 63.8%; DFS: 80.0%, 59.7%, and 48.6%; P > 0.05). The OS rates in Group A and Group B (90%, 82.3%, and 66.4%) were similar (P > 0.05). The DFS rates in Group B (50%, 31.6%, and 17.2%) were lower than that of Group A (P = 0.013).
CONCLUSIONS: The efficacy of DEA-TACE combined with RFA for untreated HCC is similar with hepatectomy. Patients with recurrent HCC could get a longer survival time through the combined treatment.
摘要：
背景：药物洗脱珠经动脉化疗栓塞（DEB-TACE）具有缓慢稳定释放的优点，局部浓度高,与传统TACE相比，药物不良反应发生率低。DEB-TACE联合序贯超声引导下射频消融(RFA)治疗抗癌效果强,副作用小,但是到目前为止，相关的长期研究较少。
目的：探讨DEB-TACE序贯联合RFA治疗原发性肝细胞癌的疗效。
方法：招募76例原发性肝癌患者，这些患者依次接受DEB-TACE联合RFA。40例未经治疗的HCC患者被纳入A组，B组包括36例复发性肝癌患者。40例接受肝切除术治疗的未经治疗的HCC患者被纳入C组。血清学检查，术前磁共振成像检查，对所有患者进行了治疗后CT增强检查.疗效分级为完全缓解（CR），部分缓解（PR），疾病稳定和疾病进展在3日，6th,和第九。所有患者随访3年,总生存期(OS),评估无病生存期(DFS).
结果：A组和C组的疗效相似（P>0.05），但丙氨酸氨基转移酶,A组谷草转氨酶和总胆红素均低于C组(均P<0.05)。CR的比例（32.5%），PR（37.5％）略高于A组（CR：27.5％，PR：35%），差异无统计学意义(χ2=0.701,P=0.873)。A组和C组没有发生与手术相关的死亡。OS(97.5%，84.7%,和66.1%)和DFS(75.0%，51.7%,A组的35.4%)，2nd,治疗后第3年与C组相似（OS：90.0％，79.7%,63.8%；DFS：80.0%，59.7%,48.6%；P>0.05）。A组和B组的OS率(90%，82.3%,和66.4%)相似(P>0.05)。B组的DFS率(50%，31.6%,和17.2%)低于A组(P=0.013)。
结论：DEA-TACE联合RFA治疗未治疗HCC的疗效与肝切除术相似。复发性HCC患者可以通过联合治疗获得更长的生存时间。
目的：探讨DEB-TACE序贯联合RFA治疗原发性肝细胞癌的疗效。
方法：招募76例原发性肝癌患者，这些患者依次接受DEB-TACE联合RFA。40例未经治疗的HCC患者被纳入A组，B组包括36例复发性肝癌患者。40例接受肝切除术治疗的未经治疗的HCC患者被纳入C组。血清学检查，术前磁共振成像检查，对所有患者进行了治疗后CT增强检查.疗效分级为完全缓解（CR），部分缓解（PR），疾病稳定和疾病进展在3日，6th,和第九。所有患者随访3年,总生存期(OS),评估无病生存期(DFS).
结果：A组和C组的疗效相似（P>0.05），但丙氨酸氨基转移酶,A组谷草转氨酶和总胆红素均低于C组(均P<0.05)。CR的比例（32.5%），PR（37.5％）略高于A组（CR：27.5％，PR：35%），差异无统计学意义(χ2=0.701,P=0.873)。A组和C组没有发生与手术相关的死亡。OS(97.5%，84.7%,和66.1%)和DFS(75.0%，51.7%,A组的35.4%)，2nd,治疗后第3年与C组相似（OS：90.0％，79.7%,63.8%；DFS：80.0%，59.7%,48.6%；P>0.05）。A组和B组的OS率(90%，82.3%,和66.4%)相似(P>0.05)。B组的DFS率(50%，31.6%,和17.2%)低于A组(P=0.013)。
结论：DEA-TACE联合RFA治疗未治疗HCC的疗效与肝切除术相似。复发性HCC患者可以通过联合治疗获得更长的生存时间。
