Kết quả điều trị ung thư biểu mô tế bào gan kích thước trên 3 cm bằng phương pháp tắc mạch hóa dầu kết hợp đốt nhiệt sóng cao tần

Aims: to assess the effect of transarterial oily ehemoembo/ization (TOCE) combined with radio frequency ablation (RFA) for patients with unresectable hepatocellular carcinoma (BCC) large than 3cm, and compare with that ofTOCE alone.Patients and methods: a prospective study conducted 224 patients with HCC at No.108 Hospital. Patients were assigned into 2 groups: one group treated by TOCE followed by RFA after 5 days and another group treated by TOCE alone. Inclussion criterias for both groups were: tumor size ranges from 3.1 cm to 8 cm, Child-Pugh A or B cirrhosis; Okuda I-II; without portal vein thrombosis and extrahepatic spreads. End points included overall survival, tumor size shrunk rate, and recurrent after treatment. Results: 121 patients in the combined group aged 58.9 + or - 11.2, male/female: 7/1. 103 patients in the TOCE alone group aged 59.7 + or - 10.6, male/female: 11/1. Mean follow up time was 20.7 months (1 -36 months). Mean survival time was 19.2 + or - 13.9 months in the combined group longer than that in TOCE alone group (15.1 + or - 10.2, p = 0.016). The 1,2,3 year survival rates were better in the combined group (100 percent, 90.6 percent, 57.9 percent) compared with in the TOCE alone group (97.4 percent, 82.6 percent, 26.6 percent, p = 0.007). The tumor shrunk rate after 3 months of treatment in the combined group (70.2 percent) was also higher than that in the TOCE group (51.2 percent,. p= 0.001). The recurrent rate was lower in the combined group compared with that in the TOCE group (17.4 percent vs 37.8 percent, p 0.001). Conclussions: In patients with cirrhotic unresectable HCC large than 3cm, chemoembolization combined with RFA is superior to TOCE alone in improving survival time, and the recurrent rate was lower in the combined group.