国际肿瘤学杂志

国际肿瘤学杂志 ›› 2019, Vol. 46 ›› Issue (11): 673-677.doi: 10.3760/cma.j.issn.1673-422X.2019.11.006

• 论著 • 上一篇    下一篇

TACE联合射频消融治疗结直肠癌肝转移的疗效及生存分析

徐毅1唐岩1丁波1刘元直1李冬扬1张焰2   

  1. 1河南省南阳市第一人民医院普外三科473012； 2解放军第九六〇医院第一门诊部，济南250031
  • 出版日期:2019-11-08 发布日期:2019-12-26
  • 通讯作者: 张焰 E-mail:279657658@qq.com

Efficacy and survival analysis of TACE combined with radiofrequency ablation in the treatment of liver metastasis from colorectal cancer

Xu Yi1, Tang Yan1, Ding Bo1, Liu Yuanzhi1, Li Dongyang1, Zhang Yan2   

  1. Xu Yi1, Tang Yan1, Ding Bo1, Liu Yuanzhi1, Li Dongyang1, Zhang Yan2
    1Third Department of General Surgery, Nanyang First People′s Hospital of Henan Province, Nanyang 473012, China; 2First Out-Patient Department, 960th Hospital of People′s Liberation Army, Jinan 250031, China
  • Online:2019-11-08 Published:2019-12-26
  • Contact: Zhang Yan E-mail:279657658@qq.com

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摘要： 目的观察肝动脉化疗栓塞术（TACE）联合射频消融（RFA）治疗结直肠癌肝转移的临床疗效及安全性。方法 回顾性分析河南省南阳市第一人民医院2014年1月至2016年1月收治的92例结直肠癌肝转移患者资料，46例患者接受TACE治疗（TACE组），46例患者接受TACE联合RFA治疗（联合组）。对比两组患者的临床疗效，分析两组患者治疗前后Karnofsky功能状态（KPS）评分的变化情况，统计两组患者并发症发生率，通过随访统计两组患者无进展生存时间（PFS）与总生存时间（OS）。结果联合组疾病控制率为82.61%（38/46），TACE组为63.04%（29/46），联合组疾病控制率高于TACE组（χ2=4.449，P=0.035）。治疗前联合组和TACE组KPS评分分别为71.84±4.37、72.22±4.26，差异无统计学意义（t=0.423，P=0.673）；治疗后两组评分均较治疗前提高，分别为79.81±6.15、75.86±6.02，联合组明显高于TACE组（t=3.108，P=0.003）。联合组患者并发症发生率为54.35%（25/46），TACE组为41.30%（19/46），两组差异无统计学意义（χ2=1.568，P=0.210）。TACE组患者中位PFS为12.6个月，中位OS为20.7个月；联合组患者中位PFS为18.9个月，中位OS为28.2个月，联合组患者PFS、OS均长于TACE组（χ2=72.025，P＜0.001；χ2=26.580，P＜0.001）。结论TACE联合RFA治疗结直肠癌肝转移疗效理想，可有效改善患者的KPS评分，延长患者PFS和OS，且不会增加并发症发生风险。

关键词: 结直肠肿瘤, 肿瘤转移, 肝动脉化疗栓塞术, 射频消融, 生存分析

Abstract: ObjectiveTo observe the clinical efficacy and safety of transhepatic arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in the treatment of colorectal cancer with liver metastasis. MethodsThe data of 92 patients with colorectal cancer with liver metastasis admitted to Nanyang First People′s Hospital of Henan Province from January 2014 to January 2016 were retrospectively analyzed. A total of 46 patients treated with TACE were selected as the TACE group, and another 46 patients treated with TACE and RFA were selected as the combined group. The clinical efficacies of the two groups were compared, and the changes of Karnofsky functional status (KPS) scores before and after treatment in the two groups were analyzed. The incidences of complications in the two groups were calculated. Patients in the two groups were followed up, and the progress-free survival (PFS) and overall survival (OS) were calculated. ResultsThe disease control rate of the combined group was 82.61% (38/46), and that of the TACE group was 63.04% (29/46). The disease control rate of the combined group was higher than that of the TACE group (χ2=4.449, P=0.035). Before treatment, the KPS scores of the combined group and the TACE group were 71.84±4.37, 72.22±4.26, with no statistically significant difference (t=0.423, P=0.673). After treatment, the KPS scores of the two groups were higher than those before treatment, and the KPS score of the combined group was higher than that of the TACE group (79.81±6.15 vs. 75.86±6.02; t=3.108, P=0.003). The incidence of complications was 54.35% (25/46) in the combined group and 41.30% (19/46) in the TACE group. The difference between the two groups was not statistically significant (χ2=1.568, P=0.210). The median PFS and OS in the TACE group were 12.6 and 20.7 months, and those in the combined group were 18.9 and 28.2 months. The PFS and OS of the combined group were longer than those of the TACE group (χ2=72.025, P＜0.001; χ2=26.580, P＜0.001). ConclusionTACE combined with RFA is effective in the treatment of liver metastasis of colorectal cancer, which can effectively improve the KPS score of patients, prolong the PFS and OS, and do not increase the risk of complications.

Key words: Colorectal neoplasms, Neoplasm metastasis, Hepatic arterial chemoembolization, Radiofrequency ablation, Survival analysis