Arsenic Trioxide Intravenous Combined With TACE To Treat Primary Hepatocellular Carcinoma :A Clinical Study

Objective:To evaluate the clinical efficacy and adverse reactions of arsenic trioxide intravenous combined with TACE in the treatment of primary hepatocellular carcinoma.Methods:75 patients with primary hepatocellular carcinoma meeting the research criteria were divided into a control group of 37 patients and an experimental group of 38 patients.The control group was treated with TACE.The 50mg/m~2 chemotherapy drug oxaliplatin and super liquefied lipiodol were infused during the operation.For embolization,patients in the experimental group were treated with a 10 mg arsenic trioxide intravenously on the basis of treatment in the control group for 14 days.After the first treatment,the patients in the two groups repeated the next cycle with an interval of 30 days.After completing 4 cycles of treatment,the objective response rate(ORR)and disease control rate of the two groups of patients were collected and analyzed.(DCR),Alpha-fetoprotein(AFP),Prothrombin time(PT),albumin(ALB),total bilirubin(TBIL),Aspartate aminotransferase(AST),Alanine aminotransferase(ALT),adverse drug reactions,and changes in quality of life for comprehensive evaluation.Results:(1)Baseline patient variables were similar between the two groups.(2)The short-term efficiay:The objective effective rate(ORR=50.0%)and disease control rate(DCR=89.5%)in the experimental group were higher than those in the control group(ORR=43.3%,DCR=81.1%)after treatment,but the two groups There was no significant difference between patients ORR and DCR(P>0.05).(3)The AFP level:The difference of AFP level between the experimental group and the control group before and after treatment was significant(P<0.05).After treatment,the AFP level in the experimental group(396.73±245.09 ng/mL)was significantly lower than that in the control group(396.73±374.09 ng/mL).The difference between the two groups was significant(P=0.049).(4)The PT level:There was no significant difference in PT level between the experimental group and the control group before and after treatment(P>0.05).There was no significant difference in the PT level(12.99±1.41 s)between the experimental group and the control group(13.02±1.40 s)after treatment(P>0.05).(5)The ALB level:There was no significant difference in ALB level between the experimental group and the control group before and after treatment(P>0.05).There was no significant difference in the ALB level(39.08±4.93 g/L)between the experimental group and the control group(39.56±4.09 g/L)after treatment(P>0.05).(6)The TBIL level:There was no significant difference in TBIL level between the experimental group and the control group before and after treatment(P>0.05).There was no significant difference in the TBIL level between the experimental group(21.22±8.10umol/L)and the control group(21.01±8.25 umol/L)after treatment(P>0.05).(7)The AST level:There was no significant difference in AST level between the experimental group and the control group before and after treatment(P>0.05).There was no significant difference in the AST level(35.83±12.73 U/L)between the experimental group and the control group(36.91±12.21 U/L)after treatment(P>0.05).(8)The ALT level:There was no significant difference in ALT level between the experimental group and the control group before and after treatment(P>0.05).After treatment,the ALT level(46.57±20.12 U/L)in the experimental group was not significantly different from that in the control group(44.38±18.21 U/L)(P>0.05).(9)The KPS score:The quality of life scores before and after treatment in the experimental group were significantly different(P=0.031).There was no significant difference in the quality of life scores between the patients in the control group before and after treatment(P>0.05).The quality of life score(86.67±10.59 points)in the experimental group was significantly improved compared with the control group(75.12±12.37 points).The difference between the two groups was significant(P=0.023).(10)Safety:There was no significant difference in the number of patients with overall adverse reactions after treatment between the control group and the experimental group(P>0.05),and no irreversible toxicities and treatment-related deaths occurred during the treatment.Conclusion:On the basis of clinical TACE treatment of primary hepatocellular carcinoma,combined with arsenic trioxide intravenous infusion can significantly improve the therapeutic effect,reduce AFP levels,improve the quality of life,and the adverse reactions are minor,which can maximize the benefit of patients,and it is worthy of further study.