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射频消融联合系统化疗治疗不可切除或术后复发肝内胆管癌的效果和安全性
Clinical effect and safety of radiofrequency ablation combined with systemic chemotherapy in treatment of unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma
文章发布日期:2018年07月06日  来源:  作者:孙巍, 丁晓燕, 陈京龙, 等  点击次数:428次  下载次数:60次

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【摘要】:目的回顾性分析经皮射频消融治疗(RFA)联合静脉化疗治疗不可切除或术后复发肝内胆管癌的效果及安全性。方法选取2011年1月-2016年12月首都医科大学附属北京地坛医院诊治的不可切除或术后复发肝内胆管癌患者。所有患者首先行RFA治疗。RFA治疗均在CT引导下完成。术后1周开始进行全身化疗,方案为吉西他滨联合顺铂(具体为吉西他滨1000 mg/m2第1、8天及顺铂25 mg/m2第1、8天,共6个周期)。主要观察指标为完全消融率、客观缓解率、至疾病进展时间、肿瘤局部进展率、生存时间和安全性。结果24例患者中共包含45个病灶,均完成RFA治疗及化疗。客观缓解率为79.2%,术后1个月肿瘤完全消融率为86.7%(39/45)。术后随访11~67个月,至随访结束肿瘤局部进展率为20.0%(9/45);中位至疾病进展时间为13.0个月;中位生存时间为28.6个月,1、2、3年生存率分别为87.3%、69.3%、32.6%。至随访结束主要副反应为血液学毒性及转氨酶升高,无手术严重并发症发生。结论RFA联合系统化疗治疗不可切除或术后复发肝内胆管癌是一种安全可行的方案。
【Abstract】:ObjectiveTo investigate the clinical effect and safety of percutaneous radiofrequency ablation (RFA) combined with systemic chemotherapy in the treatment of unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma. MethodsThe patients with unresectable or postoperative recurrent cholangiocellular carcinoma who were treated from January 2011 to December 2016 were enrolled. All patients underwent CT-guided RFA, followed by systemic chemotherapy since one week after surgery, with the regimen of gemcitabine given concurrently with cisplatin (gemcitabine 1000 mg/m2 combined with cisplatin 25 mg/m2 on days 1 and 8, for 6 cycles in total). Treatment outcome and safety were observed. ResultsThere were 45 lesions in total, and RFA and chemotherapy were performed for all lesions. The overall objective response rate was 79.2%. The complete ablation rate of the lesions at one month after surgery was 86.7% (39/45). The patients were followed up for 11-67 months after surgery, and at the end of follow-up, the rate of local progression was 200% (9/45). The median time to progression was 13.0 months, the median survival time was 28.6 months, and the 1-, 2-, and 3-yaer survival rates were 87.3%, 69.3%, and 32.6%, respectively. Major side effects included hematological toxicity and elevated aminotransferases, and there were no serious adverse events associated with RFA. ConclusionRFA combined with systemic chemotherapy is a safe and feasible regimen for unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma.
【关键字】:肝肿瘤; 导管消融术; 药物疗法, 联合; 治疗结果
【Key words】:liver neoplasms; catheter ablation; drug therapy, combination; treatment outcome
【引证本文】:SUN W, DING XY, CHEN JL, et al. Clinical effect and safety of radiofrequency ablation combined with systemic chemotherapy in treatment of unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma[J]. J Clin Hepatol, 2018, 34(8): 1717-1722. (in Chinese)
孙巍, 丁晓燕, 陈京龙, 等. 射频消融联合系统化疗治疗不可切除或术后复发肝内胆管癌的效果和安全性[J]. 临床肝胆病杂志, 2018, 34(8): 1717-1722.

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