中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (4): 282-289.doi: 10.19401/j.cnki.1007-3639.2018.04.007

• 论著 • 上一篇    下一篇

基于倾向性评分匹配法的经导管肝动脉化疗栓塞联合高强度聚焦超声治疗肝癌的生存情况分析

马 荣1,朱 辉2,龚建平1   

  1. 1. 重庆医科大学附属第二医院肝胆外科,重庆 400010 ;
    2. 重庆医科大学附属第二医院海扶中心,重庆 400010
  • 出版日期:2018-04-30 发布日期:2018-06-12
  • 通信作者: 龚建平 E-mail:gongjianping11@126.com

Survival analysis of transcatheter arterial chemoembolization combined with high intensity-focused ultrasound in the treatment of liver cancer based on propensity score matching method

MA Rong1, ZHU Hui2, GONG Jianping1   

  1. 1. Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China; 2. Department of HIFU, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
  • Published:2018-04-30 Online:2018-06-12
  • Contact: GONG Jianping E-mail: gongjianping11@126.com

摘要: 背景与目的:经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)目前仍为非手术治疗肝癌的首选方法,高强度聚焦超声(high intensity-focused ultrasound,HIFU)也在原发性肝癌的治疗中取得了一定疗效,而两者联用的效果尚不明确。该研究旨在探讨TACE联合HIFU与单纯TACE两种方法治疗原发性肝癌的临床疗效。方法:采用回顾性分析方法,选取重庆医科大学附属第二医院2015年1月—2016年8月收治的121例原发性肝癌患者的临床资料,按照临床所用不同治疗方案分成两组,即HIFU组(TACE联合组HIFU)及TACE组(单纯TACE组),HIFU组患者55例,TACE组患者66例。对资料进行倾向性匹配,比较倾向性匹配前后两组患者治疗后的临床疗效及不良反应,同时比较两组随访1年后的生存率、无进展生存期等的差异。结果:使用倾向性评分匹配法对两组间的协变量进行平衡,匹配前是否有癌栓、甲胎蛋白(alpha-fetoprotein,AFP)水平在两组间的不均衡,在匹配以后达到了均衡。匹配之后,HIFU组1年生存率为94.0%,明显高于TACE组的75.0%,差异有统计学意义(P<0.05),而无进展生存期组间差异无统计学意义(P>0.05)。结论:相比于单纯TACE治疗,TACE联合HIFU治疗可延长原发性肝癌患者1年生存率。

关键词: 高强度聚焦超声, 经导管肝动脉化疗栓塞, 联合治疗, 原发性肝癌, 倾向性匹配

Abstract: Background and purpose: Transcatheter arterial chemoembolization (TACE) is still the first choice for patients with primary liver cancer which disagree with or lose the chance of surgery. High intensity-focused ultrasound (HIFU) has already achieved a certain effect in the treatment of primary liver cancer. However, the effect of the two combined use is not clear. The purpose of this study was to investigate the therapeutic effects of TACE combined with HIFU and the sole TACE in treating primary liver cancer. Methods: With the method of retrospective analysis, 121 patients suffering from primary liver cancer were selected from the Second Affiliated Hospital of Chongqing Medical University from Jan. 2015 to Aug. 2016. They were divided into two groups, including the TACE combined HIFU group (experimental group) with 55 patients and the sole TACE group (control group) with 66 patients. The postoperative clinical effects, postoperative adverse reactions, the survival rates of 1 year and the progression-free survival were compared between these two groups. Results: The propensity score matching method was used to balance the covariates between the two groups, and the imbalance of alpha-fetoprotein (AFP) levels and with or without portal venous tumor emboli between two groups were balanced after matching. After matching, the 1-year survival rate of HIFU group was 94.0%, which was higher than that of the TACE group (75.0%), and the difference was statistically significant (P<0.05). There was no difference between the two groups in the progression-free survival (P>0.05). Conclusion: Compared with sole TACE, TACE combined with HIFU can improve the 1-year survival rate of patients with primary liver cancer.

Key words: High intensity focused ultrasound, Transcatheter arterial chemoembolization, Combined treatment, Primary liver cancer, Propensity score matching