Value Of Detection Of Targeted Molecules Associated With Drug Sensitivity In Individualized Chemoembolization For Hepatocellular Carcinoma After Resection

ObjectiveTo investigate the value of the detection of targeted molecules associated with drug sensitivity in preventive transcatheter arterial chemoembolization(TACE) for patients with hepatocellular carcinoma(HCC) after hepatectomy. Methods92 patients with HCC were undergone hepatectomy and treated with TACE in about one month after resection in the department of hepatobiliary pancreatic surgery in the fifth affiliated hospital of Zhengzhou University from May 2012 to May 2013. The patients were divided into an observation group(n=50) and a control group(n=42) according to the way in selecting chemotherapeutic agents. In the observation group, chemotherapeutic agents were selected based on the detection of targeted molecules associated with drug sensitivity, while chemotherapeutic agents were chosen empirically in the control group. All patients were followed up 2 years through telephone and outpatient. The clinical and follow-up data were analyzed retrospectively. The recurrence rate after resection, disease-free survival time, survival rate and the adverse effects of TACE were compared between two groups. Chi-square test, t test, Rank sum test and Log-rank test were applied in the statistical analysis, significance was set at P<0.05. ResultsThe 1-2-year recurrence rate of the observation group was 8% and 24% respectively. The 1-2-year recurrence rate of the control group was 23.8% and 45.2% respectively. The difference of recurrence rate of the two groups patients was of statistical significance(P<0.05). The average disease-free survival time of the observation group and the control group was(22.14±4.15) months and(19.07±5.807) months respectively, the difference of the average disease-free survival time between the two groups was statistically significant(t=2.865, P=0.005). The disease-free survival curve of the observation group differed from that of the control group(χ2=6.558, P=0.01). In the observation group, the 1-2-year survival rate was 96% and 88% respectively. In the control group, the 1-2-year survival rate was 80.95% and 71.43% respectively. Significant difference in the short-term survival rate between the two groups existed(P<0.05). As for the adverse effects, the degree of myelosuppression and gastrointestinal reaction after TACE of the observation group were lower than those of the control group, the significant difference between the two groups was observed(P<0.05). Whereas, there were no significant differences in the incidence of fever, hepatorenal dysfunction, and bellyache after TACE between the two groups(P>0.05). Conclusions1. The detection of targeted molecules associated with drug sensitivity has a clear focus in the preventive TACE of the HCC patients after hepatectomy, which is in accordance with the principle of personalized and precision medicine;2. Selection of chemotherapeutic agents based on the detection of targeted molecules can delay recurrence, prolong disease-free survival time, improve the short-term survival rate, and reduce the incidence of the adverse effects after TACE in patients with HCC after hepatectomy;3. The combination of detection of targeted molecules associated with drug sensitivity and TACE shows the promising feasibility in preventing recurrence, improving survival, and enhancing the quality of life for HCC patients after hepatectomy. The detection of targeted molecules associated with drug sensitivity has certain value in clinical application.