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PurposeTo introduce the technique and investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) in combination with simultaneous DynaCT-guided radiofrequency ablation (RFA) in the treatment of solitary large hepatocellular carcinomas (HCCs) (maximal diameter > 5 cm).
目的：介绍经动脉化疗栓塞(TACE)同步联合DynaCT引导射频消融术(RFA)治疗孤立性大肝癌(最大直径> 5cm)这一技术及其临床疗效。
Materials and methodsForty-six patients who received TACE combined with simultaneous DynaCT-guided RFA for solitary large HCCs between January and August were reviewed, and the success rate, safety, local tumor progression (LTP), and overall survival (OS) were retrospectively investigated. OS and time to progression were analyzed with the Kaplan–Meier method.
材料和方法：回顾性分析1月至8月收治的46例TACE联合DynaCT引导RFA治疗的孤立性大肝癌患者，分析治疗成功率、安全性、局部肿瘤进展(LTP)和总生存期 (OS)。采用Kaplan-Meier法分析OS及疾病进展时间。
ResultsTechnical success rate was 100%, average operative time for DynaCT-guided RFA was 45.3 ± 4.8 min, average radiation dose was 730.5 ± 78.8 mGy, and no life-threatening complications were observed. At 1-month follow-up enhanced MRI, complete remission was achieved in 82.6% of patients (38/46), and partial remission in 17.4% (8/46). The median follow-up period was 29.5 months (interquartile range 4.0–69.0 months). At 1, 2, and 3 years after surgery, the LTP rates were 4.3, 13.1, and 30.4%, respectively, and the OS rates were 89.1, 71.7, and 56.5%, respectively.
结果：技术成功率为100%，DynaCT引导RFA平均手术时间45.3±4.8 min，平均放射剂量730.5±78.8 mGy，无危及生命的并发症发生。1个月时随访进行MRI增强检查，82.6%(38/46)的患者达到完全缓解，17.4% (8/46)的患者为部分缓解。中位随访时间29.5个月(四分位间距4.0-69.0个月)。术后1、2、3年LTP分别为4.3%、13.1%、30.4%，OS分别为89.1%、71.7%、56.5%。
ConclusionDynaCT-guided TACE + RFA is safe and feasible for the treatment of solitary large HCCS. TACE combined with simultaneous RFA provides a new treatment option for solitary large HCCs in which DynaCT has important clinical value.
结论：DynaCT引导TACE + RFA治疗孤立性大肝癌安全可行。TACE同步联合RFA为治疗孤立性大肝癌提供了新的选择，且DynaCT具有重要的临床应用价值。
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