关键词: 冷循环射频消融, ¹²⁵Ⅰ粒子植入, TACE, 中期, 巨块型, 肝癌

Abstract: Objective To analyze the effect of cold cycle radiofrequency ablation combined with ¹²⁵I particle implantation and transcatheter arterial chemoembolization (TACE) on the treatment of intermediate massive liver cancer. Methods In this retrospective study, the clinical data of 79 patients with mid-stage massive liver cancer were collected from the First Affiliated Hospital of Henan University of Science and Technology from June 2020 to May 2022. Based on different treatment approaches, the participants were divided into a control group (n=40, treated with TACE in combination with ¹²⁵I particle implantation) and an observation group (n=39, treated with TACE in combination with ¹²⁵I particle implantation and cold circulation radiofrequency ablation). The clinical efficacy, adverse reactions, and serum indexes were compared between the two groups before and after treatment. Both groups of patients were followed-up until April 2024, and their survival rate and status were compared. Results The Objective response rate (ORR) and disease control tate (DCR) of observation group were 74.36% and 92.31%, respectively, which were significantly higher than 52.50% and 75.00% of control group (P<0.05). After treatment, the levels of CD3⁺ and CD4⁺/CD8⁺ in the observation group were (64.38±5.73) % and (1.76±0.35), respectively, which were significantly higher than those of (57.46±5.12) % and (1.17±0.25) in the control group. The alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alpha fetoprotein (AFP) levels in the observation group were (56.38±15.85) U/L, (65.48±21.53) U/L, and (325.28±26.35) μg/L, respectively, which were significantly lower than those of (73.28±18.54) U/L, (84.72±23.57) U/L, and (438.49±34.29) μg/L in the control group (all P<0.05). In terms of prognosis, the 12-month and 24-month survival rates in the observation group were 97.30% and 80.60%, respectively, which were significantly higher than those of 87.20% and 60.00% in the control group. The median progression-free-survival (PFS) and overal survival (OS) in the observation group were 32 months and 33 months, respectively, which were significantly longer than 26 months and 27 months in the control group (P<0.05). The incidences of adverse reactions were 20.00% and 33.33% in control group and observation group, respectively, and there was no statistical significance between groups (P>0.05). Conclusion Cold circulation radiofrequency ablation combined with ¹²⁵I particle implantation and TACE is effective in the treatment of middle stage massive liver cancer, which can improve liver function and immune function, reduce AFP level, prolong survival time, and do not increase the occurrence of adverse reactions.

Key words: Cold cycle radiofrequency ablation, ¹²⁵I particle implantation, TACE, Mid-term, Giant block type, Liver cancer