Analysis Of The Therapeutic Effect Of Traditional Transcatheter Arterial Chemoembolization And Drug-Loaded Microsphere Embolization On Liver Metastasis Of Colorectal Cancer

Objective: In recent years,the clinical application of TACE in patients with colorectal liver metastasis has shown good anti-tumor effect and survival benefits.However,cTACE uses lipiodol containing chemotherapeutic drugs(which can spread to the peripheral circulation),resulting in a relatively high incidence of systemic side effects,and the application of DEB-TACE can solve this problem.Because DEB-TACE uses microspheres as drug carriers it can significantly reduce the systemic chemical drug concentration and increase the drug concentration in tumor tissue.However,it is controversial whether DEB-TACE is superior to cTACE in the efficacy and safety of colorectal cancer patients with liver metastasis.Therefore,the purpose of this study was to compare the efficacy,survival rate and incidence of adverse events between DEB-TACE and cTACE in the treatment of colorectal cancer patients with liver metastasis.Methods:The clinical data of 50 patients with liver metastasis of colorectal cancer treated with DEB-TACE or cTACE in the affiliated Hospital of Jining Medical College of Shandong Province from October 1,2018 to August 1,2019 were analyzed retrospectively.Among them,25 cases were treated with DEB-TACE and 25 cases with cTACE.The follow-up period is 14 months.The liver function indexes and tumor markers of the two groups wereanalyzed before and after operation,and the postoperative adverse reactions and imaging examinations at 1 month,3 months and 6 months after operation were recorded.The tumor treatment response was evaluated according to the improved solid tumor reaction evaluation standard mRECIST,and the overall survival time((OS))of the patients was calculated.SPSS22.0 statistical software was used for statistical analysis.Wilcoxon rank sum test or chi-square test was used to compare the two groups.Kaplan-Meier method was used to draw the survival curve of the two groups.Results: A review of 50 patients who were treated with DEB-TACE or cTACE in the Affiliated Hospital of Jining Medical College from October 1,2018 to August 1,2019.It was found that there was no significant difference in sex,age,hepatitis B,liver cirrhosis,ECOG score,liver tumor distribution,liver function and tumor indexes between the two groups.It was found that ALT,AST,TBiL increased and ALB decreased in both groups three days after operation,and these indexes returned to normal range after one month.The effects of the two treatments on the changing trend of liver function were evaluated,and it was found that there was no significant difference in the damage of liver function between the two treatments(P >0.05).There may be some complications in TACE,the most common of which ispost-embolic syndrome.(PES),includes fever,nausea and vomiting,fatigue,abdominal pain and diarrhea.There were 15 patients with adverse reactions in the conventional embolization chemotherapy group,accounting for about60.0% of the conventional embolization group,and 13 patients in the drug-loaded microsphere embolization group,accounting for about 52% of the drug-loaded microsphere group,which was lower than that in the conventional embolization group.however,according to statistical analysis,there was no significant difference in the incidence of adverse events between the two groups.The objective response rates of cTACE and DEB-TACE in M1(24% vs36%),M3(73.3% vs 82.3%),M6(71.4% vs 88.9%),it is considered that the use of DEB-TACE can improve the objective reflection rate of patients,but there is no statistical significance P > 0.05.The average survival time of cTACE was 9.9 months(95%CI8.047-11.775 months);the average survival time of DEB-TACE was 10.6months(95%CI8.971-13.806 months).Survival analysis was performed by Kaplan-Meier method and logarithmic rank test: there was no difference in postoperative survival between the two groups.Conclusion:(1)DEB-TACE is safe and feasible in the treatment of colorectal cancer patients with liver metastasis,and there is no significantdifference in the incidence of adverse events and postoperative survival time between the two groups.(2)DEB-TACE has some advantages in patients with liver metastasis of colorectal cancer,but it needs to be further explored.