| 张仲一,陈敏华,严昆,杨薇,吴薇,李荣杰.经皮超声引导下射频消融治疗结直肠癌肝转移疗效分析[J].中国医学影像技术,2015,31(8):1246~1250 |
| 经皮超声引导下射频消融治疗结直肠癌肝转移疗效分析 |
| Outcome of percutaneous ultrasound-guided radiofrequency ablation for colorectal liver metastases |
| 投稿时间：2015-02-09 修订日期：2015-06-26 |
| DOI：10.13929/j.1003-3289.2015.08.034 |
| 中文关键词: 结直肠肿瘤 肿瘤转移 肝 射频消融 存活率 治疗结果 预后因素 |
| 英文关键词:Colorectal neoplasms Neoplasm metastasis Liver Radiofrequency ablation Survival rate Treatment outcome Prognostic factor |
| 基金项目:国家自然科学基金面上项目(81471768)、"北京市科学技术委员会"资助(Z111107067311026)。 |
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| 中文摘要: |
| 目的 探讨经皮超声引导下射频消融(RFA)治疗结直肠癌肝转移(CRLM)的疗效及预后因素。方法 回顾性分析192例接受经皮超声引导下RFA治疗的CRLM患者临床及影像资料,其中原发肿瘤为结肠癌者105例,直肠癌者87例。结果 192例患者共接受RFA治疗302例次,肝转移灶共437个。首次RFA治疗后1个月肿瘤总体灭活率93.59%(409/437)。肿瘤局部复发率为11.21%(49/437),平均复发时间为RFA治疗后(9.34±7.25)个月(2~34个月)。治疗后肝内新生转移灶发生率48.96%(94/192)。患者1、3、5年总体生存率分别为87.0%、40.8%、16.5%。单因素分析结果显示,肿瘤数目(P=0.003)、最大径(P=0.001)、肝内分布(P=0.001)及治疗后1个月肿瘤灭活情况(P=0.007)是影响患者生存率的潜在危险因素。多因素分析结果显示,肿瘤数目(P=0.001)及最大径(P=0.001)为患者生存率的独立影响因素。RFA治疗后较严重并发症发生率为3.31%(10/302),未发生治疗相关性死亡。结论 RFA是一种安全、有效的CRLM治疗方法,肿瘤最大径≤3 cm及单发肝转移灶患者预后较好。 |
| 英文摘要: |
| Objective To explore the effect and prognostic factors of percutaneous ultrasound-guided radiofrequency ablation (RFA) for colorectal liver metastases (CRLM). Methods The clinical and imaging data of 192 patients with CRLM who underwent percutenous ultrasound-guided RFA were retrospectively analyzed. There were 105 cases with the primary tumor of colon carcinoma and 87 cases with the primary tumor of rectum carcinoma. Results Percutenous ultrasound-guided RFA was performed on totally 192 patients with 437 lesions for 302 sessions. The overall ablation success rate was 93.59% (409/437) 1 month after RFA. The local recurrent rate was 11.21% (49/437) and the mean interval between RFA and recurrence was (9.34±7.25) monthes (ranged 2-34 monthes). And the new metastasis rate was 48.96% (94/192). The overall survival rates of 1, 3 and 5year was 87.0%, 40.8% and 16.5%, respectively. Tumor number (P=0.003), diameter (P=0.001), distribution (P=0.001) and success ablation of 1 month after RFA (P=0.007) were potential risk factors for survival rates by univariate analyses. Tumor number (P=0.001) and diameter (P=0.001) were independent prognostic factors by Cox multivariate model. The severe complication rate was 3.31% (10/302), and no treatment-related death occurred. Conclusion RFA is a safe and effective therapeutic option for colorectal liver metastases, especially for those with diameter ≤3 cm and solitary tumor. |
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