射频消融术与立体定向放射治疗原发性小肝癌的临床效果比较

肖金成; 郭雷鸣; 康鑫鑫; 白淇文; 张俊岭; 李靖

doi:10.3971/j.issn.1000-8578.2017.17.0613

射频消融术与立体定向放射治疗原发性小肝癌的临床效果比较

Comparison of Efficiency and Safety Between Radiofrequency Ablation and Stereotactic Body Radiotherapy on Primary Small Hepatocellular Carcinoma

摘要

摘要:
目的比较射频消融术（radiofrequency ablation, RFA）和立体定向放射治疗（stereotactic body radiotherapy, SBRT）对原发性小肝癌患者的临床疗效及安全性。
方法回顾性分析2013年6月至2015年3月河南省肿瘤医院收治的肝癌患者86例，RFA组49例、SBRT组37例。比较两组近期疗效、不良反应发生情况以及随访2年总生存率和肿瘤病灶局部控制率。
结果两组患者基线资料差异无统计学意义。RFA组患者近期治疗有效率为81.9%，疾病控制率达到95.9%；SBRT组近期有效率为83.8%，疾病控制率达到91.9%，两组差异无统计学意义。两组治疗后均未出现严重并发症。RFA组治疗后1年和2年总生存率为95.9%和85.7%，SBRT组分别为91.9%和83.8%，两组差异无统计学意义。
结论 RFA介入治疗与SBRT治疗对肿瘤直径≤5 cm的单发肝癌患者具有较好的近期和远期疗效，对于不适合手术切除的肝癌患者，立体定向放疗可以作为射频消融术治疗的一种替代手段。

Abstract:
Objective To compare the clinical efficiency and safety between radiofrequency ablation (RFA) and stereotactic body radiotherapy(SBRT) on primary small hepatocellular carcinoma patients with tumor diameter ≤5 cm.
Methods We retrospectively analyzed the clinical data of 86 patients with hepatocellular carcinoma in He'nan Province Tumor Hospital from June 2013 to March 2015, 49 cases in RFA group and 37 cases in SBRT group. The short-term clinical efficiency and adverse effects were compared. The 2-year overall survival(OS) and local control(LC) rate were followed up.
Results There was no significant difference in the baseline characteristics between two groups. Short-term efficiency and the local control rate were 81.9% and 95.9% in RFA group, while 83.8% and 91.9% in SBRT group, with no significant difference. No severe complications occurred in any patients after treatment. The 1-and 2-year overall survival rates were 95.9% and 85.7% in RFA group, while 91.9% and 83.8% in SBRT group, with no significant difference.
Conclusion RFA has comparable short-and long-term effects as SBRT on single hepatocellular carcinoma with tumor diameter ≤5 cm, and SBRT may serve as an alternative option of RFA on hepatocellular carcinoma patients who were unavailable for surgical resection.

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