| Objection: 1.To study the method and clinical effect of intra-arterial Chemoradioembolization with 32-P glass microsphere for treatment of liver cancer 2.To investigate the effect of preventing the regeneration of neoplasitc vascular, and to explore the mechanism of clinical effect. 3. To approximately reckon absorbed radiation doses in tumor tissue snd nomal liver tissue, and to evaluate the relationship between doses and effect. 4.To analyze the factors which affect the prognosis of patients treated by intra-arterial Chemoradioembolization with 32-P glass microsphere.Material and method: From Mar. 2001 to Jun 2002, 30 patients with unresectable liver cancer were treated with radioembolization of 32-P Glass Microsphere combined with itra-arterial chemoembolization. The age of the patients ranged from 42 to 73 years, mean54.03±7.41 years. In term of criterion of Child class 19 patients were in child A class, 11 in B. Via hepatic-artery the suspention of 32-P glass microsphere mixed with lipiodol-ultrafluid(5~20ml) and EPI(lOmg) was firstly infused, then diluted 5-FU (1000mg), IFO(2g) , THP (lOmg) sequentially, at last glutin sponge granules at some circumstances. Segmental and half-hepatic embolization were used for topical diseases. 26 patients with unresectable liver cancer were randomly selected as control group in the same time which ranged from 40 to 70 years, mean 53.87±6.97 years, with16 patients in Child A class, 9 patients in B class, and 1 patient in C class.Result: l.The estimative method of absorbed radiation doses. T/N ratio ranged from 1.5:1 to 5.8:1, mean 3.14 + 0.93:1; and L% ranged from less than 0.5% to 3.6%, mean 1.24%, The absorbed radiation doses was acquired from the formula of absorbed radiation doses of internal radiation therapy with 32-P based on the volume of liver and tumor from CT scans, T/N ratio and L% from 3 bremsstrahung imaging. 2.The response of treatment. (1).According to volume of tumor: In the treatment group, a complete response was seen in Opatients (0%), partial response 10 patients(33.3%), minimal response 11 patients (36.7%), stable disease 6 patients(20%) and progressive disease in 3 patients(10%) respectively. The rate of response (CR+PR+MR) was 70%. In 17 patients that the doses to tumor was below 120 Gy, a partial response was seen in 1 patients, minimal response 7 patients, stable disease 6 patients and progressive disease 3 patients, while the doses above 120 Gy in rest patients, we can see a partial response in 9 patients, minimal response 4 patients, and no stable disease or progressive disease, the 26 patients treated with TACE showed partial response in 5 patients(19.2%), minimal response 6 patients(23.1%), stable disease 10 patients(38.5%) and progressive disease 5 patients(19.2%), the rate of response (CR+PR+MR) was 42.3%. The difference between the treat group with 32-P glass microsphere and the control group with TACE was statistically significant (p<0.05). (2)according to the level of AFP in serum: the level of AFP descended significantly in the treatment group, (3).according to survival: the survival rate of 6,12,18 months was 100%, 76.67%, 42.86% in treatment group and 92.31%, 61.47%, 20.28% in control group, respectively. (4) The effect of preventing the regeneration of neoplasitc vascular: chemoradioembolization with 32-P glass microsphere can prevent the regeneration of neoplasitc vascular 3.Complications. The differentlevel of fever, abdominal pain and abdominal distension were found in almost all patients after interventional therapy with 32-P glass microsphere and these symptoms continued 3-4 days. The symptoms of abdominal pain and abdominal distension were felt right now after injection in 5 patients. The different degree of impairment in liver function in 5-10 days after interventional therapy can recover to the level of pre-operation in more than 20 days. 4.The effective factors of prognostic. The analysis with multiple factors demonstrated that the foctors such as doses of internal radiation, liver scleroses, volume of tumor,...
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