【摘要】 目的　研究射频联合化疗治疗不宜切除小肝癌的临床安全性以及对肝癌原位复发率的影响。方法　≤ 3cm不宜切除的原发性肝癌患者 38例 ,其中 2 7例 1年随访资料完整。根据射频与射频联合全身化疗的随机分组方案入选标准 ,射频组 12例 ,射频联合全身化疗组 15例。在超声引导下行多电极射频治疗。化疗方案为 :表阿霉素 5 0mg ,d1,3,静推 ;顺铂 4 0mg ,d1,3,静滴 ;氟脲嘧啶 5 0 0mg ,d1,2 ,3,静滴。观察患者术后 1,4 ,7d的肝功能、血常规和并发症 ,术后 1,6 ,12个月复查CT(增强 ) ,评价两组患者治疗的安全性及原位复发率。结果　两组射频术后 1个月 ,均无原位复发。射频联合全身化疗组 6 ,12个月的原位复发率较单射频组明显下降 ,差异有显著性。两组均无严重并发症 ,肝功能、血常规变化差异无显著性。结论　对≤ 3cm不宜切除的原发性肝癌患者 ,射频联合全身化疗是安全的 ,并能降低肝癌原位复发率更多还原

【Abstract】 Objective To study the clinical safety and effect on local recurrence in unresectable small hepatocellular carcinoma treated by radiofrequency ablation (RFA) with and without chemotherapy through a prospective randomized trial. Methods Thirty-eight unresectable small hepatocellular carcinoma patients with diameter ≤3 cm were selected, of which 27 patients have been followed up for 1 year. Through a prospective randomized trial, 12 patients were in the RFA group and 15 patients in the RFA combined with systemic chemotherapy group. RFA was given image-guided. The regimen of systemic chemotherapy: EADM 50 mg on day 1, 3; CDDP 40 mg on day 1, 3 and FUDR 500 mg on day 1, 2, 3. After RFA treatment, liver function, WBC count and complications were observed on day 1, 4, 7; CT scan was performed in 1, 6, 12 months. The safety and local recurrence were analyzed. Results There was no local recurrence of the tumor in the two groups 1 month after RFA treatment. The 6- and 12-month local recurrence rates were significantly lower in the combined group than that in RFA group alone (P<0.01). There were no severe complications in the two groups, and nor was there any significant difference in liver function and WBC count. Conclusion RFA combined with systemic chemotherapy is safe, and it can reduce the local recurrence of unresectable small hepatocellular carcinoma ≤3 cm in diameter.更多还原