摘要
目的探讨胆管癌根治性切除术后肝转移经导管肝动脉化疗栓塞(TACE)联合射频消融(RFA)治疗的疗效和安全性。方法收集2009年5月至2012年5月11例胆管癌根治性切除术后肝转移患者,先在DSA下行TACE,1个月后根据复查情况在CT引导下行RFA。术后定期进行CT、血常规、肝功能等检查,观察并记录患者病灶变化情况、术后并发症及生存期等。结果所有患者均成功完成TACE和RFA,并且在1次或多次RFA治疗后转移病灶完全坏死,发生肿瘤局部进展的中位时间为4.5个月,自首次发现肝转移中位生存时间为13个月。术后常见不良反应为肝区疼痛、发热等,均给予对症处理后好转。仅2例患者复查出现肝脓肿,白细胞升高,给予抽吸引流及抗生素治疗后好转。观察期内未出现由手术或手术并发症直接致死病例。结论 TACE联合RFA能够有效的控制胆管癌根治性切除术后肝转移患者肝内病灶的进展,延长患者生存期,提高患者生存质量。
Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA） in treating hepatic metastases after radical resection of cholangiocarcinoma. Methods A total of 11 patients with hepatic metastases after radical resection of cholangiocarcinoma, who were admitted to authors＇ hospital during the period from May 2009 to May 2012, were enrolled in this study. After contraindications were excluded, TACE under DSA guidance was performed, and one month later CT-guided RFA was carried out. After the treatment, CT scanning, routine blood test, liver function examination, etc. were conducted regularly. The imaging changes of the lesion, the postoperative complications and the survival time were recorded, and the results were analyzed. Results Successful TACE and RFA were accomplished in all patients. Complete necrosis of the metastatic lesions after one or several RFA procedures was observed. The median time of the deterioration in local tumor was 4.5 months. And the median survival time after initial detection of hepatic metastasis was 13 months. The common postoperative reactions included pain on hepatic region, fever, etc., which were relieved soon after symptomatic medication. Only two patients developed liver abscess with an increase in leukocyte count, which was improved after percutaneous drainage and antibiotic therapy. No death due to surgery or surgery-related complications occurred during the observation period. Conclusion Preliminary results indicate that TACE combined with RFA can effectively control the hepatic metastases after radical resection of cholangiocarcinoma, prolong the patient＇s survival time, and improve the quality of life.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第11期954-958,共5页
Journal of Interventional Radiology
关键词
胆管癌
肝转移
射频消融
化疗栓塞
radiofrequency ablation
chemo-embolization
cholangiocarcinoma
hepatic metastasis
