| Background and ObjectivePrimary liver cancer is a common malignant tumor of digestive system with high incidence rate, high mortality rate, low early diagnosis rate of the epidemiological characteristics, most patients has lost the chance of operation when they were found tumor. At present, TACE has been widely used in the treatment of patients with advanced hepatocellular carcinoma. But for patients with advanced hepatocellular carcinoma, especially the patients with large HCC, any single treatment plan has limitations. In recent years, RFA has become a new effective therapy for the treatment of patients with advanced hepatocellular carcinoma. Analyze the characteristics of the two treatments, we found the treatment of TACE combined with RFA may achieve good therapeutic effect. This study aims to investigate the therapeutic efficacy and survival rate of transarterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in large hepatocellular carcinoma. MethodsThe clinical data of 67 patients with large hepatocellular carcinoma, who were admitted to the second affiliated hospital of Zhengzhou University to receive treatment during the period from July 2011 to July 2014, were retrospectively analyzed. According to the treatment plan, the patients were divided into the control group(receiving only TACE, n=32) and the study group(receiving TACE together with RFA, n=35). The two groups were treated with TACE chemotherapy firstly, using 5-FU(500 mg/m2) and oxaliplatin(130 mg/m2). The embolization is lipiodol, the dose of iodized oil is calculated according to the tumor size. The two groups were treated with TACE once every times, up to 3 times. The control group was treated with TACE alone, the study group was treated with RFA after 30 days. Located under the guidance of B ultrasound or CT, multiple overlapping and multiple needle ablation were used according to the location, the size and shape of the tumor. The ablation range was completely covered by the tumor and more than 0.5-1.0 cm. Referring to mRECIST evaluation, the efficacy were determined in all the patients and compared beteween the two groups respectively in 1 and 3 months, and the postoperative cumulative recurrent rates were also analyzed respectively. Results1. One month after the treatment, the CR of the patients in the research group was 68.5% and the PR was 22.8% which were higher than those of the patients in the control group(40.6% and 46.8%) with statistically significant differences(P=0.022, P=0.039), but there are no statistically significant differences in ORR and DCR(P=0.602, P=0.136). Three months after the treatment, the PD of the patients in the research group was 25.9% which was higher than that of the patients in the control group(6.5%) with statistically significant differences(P=0.046), and there are statistically significant differences in ORR and DCR(P=0.020, P=0.046).2. It’s worthy to reduce the AFP level of the serum, and there are statistically significant differences(P=0.011).3. The 1, 2, 3-year of survival rates in the research group were 74.3%, 44.1% and 20.5% respectively, while as were 52.8%, 23.1%, and 7.9% respectively in the research group with statistically significant differences(P=0.035). Conclusion1. In 3 months, the combined treatment has a higher level of objective effective rate and disease control rate with statistically significant differences. And it’s worthy to reduce the AFP level of the serum.2. Combination use of TACE and RFA can effectively prolong the survival time of patients with large HCC and has important clinical significance.3. Both the combined treatment and the TACE are safety and tolerability, and there are no statistically significant differences on the incidence rate of adverse reaction between the two groups. |
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