近日,，由山東大學(xué)齊魯醫(yī)院消化內(nèi)科副教授程寶泉作為第一作者及通訊作者撰寫的論文“Chemoembolization combined with radiofrequency ablation for patients with hepatocellular carcinoma larger than 3 cm”在世界著名雜志《美國醫(yī)學(xué)協(xié)會(huì)期刊》（JAMA）299卷14期發(fā)表,，是該雜志此期第一篇論文。
程寶泉利用醫(yī)院豐富的臨床資料,，結(jié)合國外在該研究領(lǐng)域的先進(jìn)技術(shù),、科學(xué)思維和臨床治療經(jīng)驗(yàn)，探討原發(fā)性肝癌治療新方法,。該研究對肝癌腫瘤大于3cm的肝癌患者,，分別選擇結(jié)合治療（transarterial chemoembolization combined with radiofrequency ablation therapy）和單獨(dú)TACE或RFA治療，通過首要觀察點(diǎn)生存期（survival）和次要觀察點(diǎn)腫瘤反應(yīng)率（objective response rate）,，發(fā)現(xiàn)結(jié)合治療優(yōu)于單獨(dú)治療,。原發(fā)性肝細(xì)胞肝癌（hepatocellular carcinoma, HCC）在我國為第二位癌癥死亡病因，盡管包括手術(shù)等綜合治療發(fā)展迅猛,，但HCC五年生存率仍很低,。因此，尋找HCC的治療新方法十分必要,。程寶泉的研究結(jié)果為治療原發(fā)性肝癌提供了新思維,，具有較高的學(xué)術(shù)價(jià)值和臨床應(yīng)用前景。哈佛大學(xué)醫(yī)學(xué)院教授Andrew X.Zhu 和Ghassan K.Abou-Alfa為該論文撰寫了Editorial,。哈佛大學(xué)的兩位教授在長達(dá)三頁的editorial paper中高度贊揚(yáng)了該論文的學(xué)術(shù)和臨床應(yīng)用價(jià)值,。（來源：山東大學(xué) 趙永鑫）
生物谷推薦原始出處：
（JAMA），299(14):1669-1677,，Bao-Quan Cheng,，Cui-Hua Yi
Chemoembolization Combined With Radiofrequency Ablation for Patients With Hepatocellular Carcinoma Larger Than 3 cm
A Randomized Controlled Trial
Bao-Quan Cheng, MD, PhD; Chong-Qi Jia, PhD; Chun-Tao Liu, MD; Wei Fan, MD; Qing-Liang Wang, MD; Zong-Li Zhang, MD, PhD; Cui-Hua Yi, MD, PhD
Context Transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) therapy has been used for patients with large hepatocellular carcinoma tumors, but the survival benefits of combined treatment are not known.
Objective To compare rates of survival of patients with large hepatocellular carcinoma tumors who received treatment with TACE combined with RFA therapy (TACE-RFA), TACE alone, and RFA alone.
Design, Setting, and Patients Randomized controlled trial conducted from January 2001 to May 2004 among 291 consecutive patients with hepatocellular carcinoma larger than 3 cm at a single center in China.
Intervention Patients were randomly assigned to treatment with combined TACE-RFA (n = 96), TACE alone (n = 95), or RFA alone (n = 100).
Main Outcome Measures The primary end point was survival and the secondary end point was objective response rate.
Results During a median 28.5 months of follow-up, median survival times were 24 months in the TACE group (3.4 courses), 22 months in the RFA group (3.6 courses), and 37 months in the TACE-RFA group (4.4 courses). Patients treated with TACE-RFA had better overall survival than those treated with TACE alone (hazard ratio [HR], 1.87; 95% confidence interval [CI], 1.33-2.63; P < .001) or RFA (HR, 1.88; 95% CI, 1.34-2.65; P < .001). In a preplanned substratification analysis, survival was also better in the TACE-RFA group than in the RFA group for patients with uninodular hepatocellular carcinoma (HR, 2.50; 95% CI, 1.42-4.42; P = .001) and in the TACE-RFA group than the TACE group for patients with multinodular hepatocellular carcinoma (HR, 1.99; 95% CI, 1.31-3.00; P < .001). The rate of objective response sustained for at least 6 months was higher in the TACE-RFA group (54%) than with either TACE (35%; rate difference, 0.19; 95% CI, 0.06-0.33; P = .009) or RFA (36%; rate difference, 0.18; 95% CI, 0.05-0.32; P = .01) treatment alone.
Conclusion In this patient group, TACE-RFA was superior to TACE alone or RFA alone in improving survival for patients with hepatocellular carcinoma larger than 3 cm.
