Clinical effect of TACE combined with RFA and 125I radioactive seed implantation in treatment of massive liver cancer

doi:10.3877/cma.j.issn.2095-5782.2019.02.003

Abstract

Abstract:

Objective:

To investigate the clinical value of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and ¹²⁵I radioactive seed implantation for the treatment of liver cancer (≥10 cm) .

Methods:

Fifty-four patients with live cancer clinical or pathological verified of ≥10 cm in our hospital were selected, and all patients underwent TACE. Patients were randomly divided into radiofrequency ablation group (TACE+RFA, control group, n=28) and RFA plus ¹²⁵I radioactivity seed implantation group (TACE+RFA+¹²⁵I, combined group, n=26) . All patients were followed up for 1 to 37 months. The treatment efficiency and clinical control rate were compared between the two groups. Survival analysis was performed by Kaplan-Meier. Log-rank test was used to compare the survival curves.

Results:

The effective rate of the combined group was higher than that of the control group (61.5% vs. 32.1%) , with significant difference (χ²=4.685, P=0.030) . The median PFS in combined group and control group was 9 months and 5 months (P=0.010) , and the OS in combined group was longer than that in control group (11 months vs. 6 months, P=0.079) .

Conclusions:

The sequential therapy with TACE, RFA and radioactive particle has advantages in treating liver cancer with the diameter ≥10 cm. The PFS and tumor remission rate in combined group were more favorable than those in control group.

Key words: Hepatocellular carcinoma, Radiofrequency ablation, Therapeutic effect, Radiology, ¹²⁵I radioactivity seed implantation

Xihui Ying, Jianfei Tu, Li Chen, Dengke Zhang, Fazong Wu, Jiansong Ji. Clinical effect of TACE combined with RFA and ¹²⁵I radioactive seed implantation in treatment of massive liver cancer[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2019, 07(02): 101-105.

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https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2019/V07/I02/101

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References 16

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临床资料		对照组（n=28）	联合组（n=26）	统计量	P值
性别（男/女，例）		26/2	24/2	χ²<0.001	>0.999
年龄（岁，±s）		58.64±8.52	59.06±11.60	t=0.152	0.879
病毒标志（B/C/NBNC，例）		20/1/7	20/0/6	χ²=1.389	0.499
肝功能Child-Pugh分级（A级/B级，例）		14/14	14/12	χ²=0.080	0.777
甲胎蛋白>400 ng/ml[例（%）]		20（71.4）	19（73.1）	χ²=0.018	0.893
病灶平均直径（cm，±s）		13.0±2.4	12.1±3.4	t=1.256	0.215
肿瘤临近结构^Δ[例（%）]		?	?	?	?
?	血管	2（7.1）	2（7.7）	χ²<0.001	>0.999
?	胆囊	0（0）	1（3.8）	χ²=0.001	0.970
?	膈肌	3（10.7）	4（15.4）	χ²=0.011	0.916
?	胃肠道	2（7.1）	1（3.8）	χ²<0.001	>0.999
肿瘤BCLC分期（A/B/C/D，例）		0/26/2/0	0/25/1/0	χ²<0.001	>0.999

临床资料		对照组（n=28）	联合组（n=26）	统计量	P值
性别（男/女，例）		26/2	24/2	χ²<0.001	>0.999
年龄（岁，±s）		58.64±8.52	59.06±11.60	t=0.152	0.879
病毒标志（B/C/NBNC，例）		20/1/7	20/0/6	χ²=1.389	0.499
肝功能Child-Pugh分级（A级/B级，例）		14/14	14/12	χ²=0.080	0.777
甲胎蛋白>400 ng/ml[例（%）]		20（71.4）	19（73.1）	χ²=0.018	0.893
病灶平均直径（cm，±s）		13.0±2.4	12.1±3.4	t=1.256	0.215
肿瘤临近结构^Δ[例（%）]		?	?	?	?
?	血管	2（7.1）	2（7.7）	χ²<0.001	>0.999
?	胆囊	0（0）	1（3.8）	χ²=0.001	0.970
?	膈肌	3（10.7）	4（15.4）	χ²=0.011	0.916
?	胃肠道	2（7.1）	1（3.8）	χ²<0.001	>0.999
肿瘤BCLC分期（A/B/C/D，例）		0/26/2/0	0/25/1/0	χ²<0.001	>0.999

组别	例数	疗效				有效率（%）	局部控制率（%）
组别	例数	CR	PR	SD	PD	有效率（%）	局部控制率（%）
联合组	26	1	15	6	4	61.5	84.6
对照组	28	0	9	8	11	32.1	60.7
χ²值	?	0.001	3.564	0.211	3.839	4.685	3.839
P值	?	0.970	0.059	0.645	0.050	0.030	0.050

组别	例数	疗效				有效率（%）	局部控制率（%）
组别	例数	CR	PR	SD	PD	有效率（%）	局部控制率（%）
联合组	26	1	15	6	4	61.5	84.6
对照组	28	0	9	8	11	32.1	60.7
χ²值	?	0.001	3.564	0.211	3.839	4.685	3.839
P值	?	0.970	0.059	0.645	0.050	0.030	0.050

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