肝细胞癌经皮冷冻消融术和射频消融术对比的多中心随机对照试验

Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma
2015-09-20 15:24发表评论
作者:Wang C., Wang H., Yang W., Hu K., Xie H., Hu K.-Q., Bai W., Dong Z., Lu Y., Zeng Z., Lou M., Wang H., Gao X., Chang X., An L., Qu J., Li J., Yang Y.
机构: 北京302医院肝细胞癌治疗研究中心
期刊: HEPATOLOGY2015年5月5期61卷

Radiofrequency ablation (RFA) is considered a curative treatment option for hepatocellular carcinoma (HCC). Growing data have demonstrated that cryoablation represents a safe and effective alternative therapy for HCC, but no randomized controlled trial (RCT) has been reported to compare cryoablation with RFA in HCC treatment. The present study was a multicenter RCT aimed to compare the outcomes of percutaneous cryoablation with RFA for the treatment of HCC. In all, 360 patients with Child-Pugh class A or B cirrhosis and one or two HCC lesions≤4 cm, treatment-naïve, without metastasis were randomly assigned to cryoablation (n=180) or RFA (n=180). The primary endpoints were local tumor progression at 3 years after treatment and safety. Local tumor progression rates at 1, 2, and 3 years were 3%, 7%, and 7% for cryoablation and 9%, 11%, and 11% for RFA, respectively (P=0.043). For lesions >3 cm in diameter, the local tumor progression rate was significantly lower in the cryoablation group versus the RFA group (7.7% versus 18.2%, P=0.041). The 1-, 3-, and 5-year overall survival rates were 97%, 67%, and 40% for cryoablation and 97%, 66%, and 38% for RFA, respectively (P=0.747). The 1-, 3-, and 5-year tumor-free survival rates were 89%, 54%, and 35% in the cryoablation group and 84%, 50%, and 34% in the RFA group, respectively (P=0.628). Multivariate analyses demonstrated that Child-Pugh class B and distant intrahepatic recurrence were significant negative predictors for overall survival. Major complications occurred in seven patients (3.9%) following cryoablation and in six patients (3.3%) following RFA (P=0.776). Conclusion: Cryoablation resulted in a significantly lower local tumor progression than RFA, although both cryoablation and RFA were equally safe and effective, with similar 5-year survival rates. © 2014 by the American Association for the Study of Liver Diseases.

 

通讯机构: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302nd Hospital, Beijing, China
学科代码:感染病学   关键词:肝细胞癌 经皮冷冻消融术 射频消融术 ,中国作者重要发表 爱思唯尔医学网, Elseviermed
来源: Scopus
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