| Objective:To explore the clinic curative effect, the safty and the toxic-side role on the double enterventional targeting treatment for hepatocellular carcinoma (HCC) in middle-late period in order to improve the quality of patients lives and their survival ratio. Methods: (1) the grouping methods: 66 patients with HCC were analyzed retrospectively from March 1998 to December 2003. Transcatheter arterial chemoembolization ( TACE ) combining portal venous chemotherapy ( PVC ) regularly through to tally implantable drag deliver system ( DDS ) were performed in 36 cases as theropeutic group; The 30 cases were treated with TACE alone as control group. (2) Hepotic artery intervention: In exploratory laparotomy an indewelling catheter was introduced to the artery of the tumor through right gastroepiploic artery according to the colored part by injecting indigo through the catheter and the port was implanted subcutaneously in the right upper abdom and connected with catheter, or transfemoral artery Seldingers catheteriztion was undertaken by introducing the catheter into theartery of the tumor. (3) portal vein. Intervention: An indewelling catheter was introduced to the portal vein through the right gastroepiploic vein in exploratory laparotomy or percutaneous, (4)arterial chemoembolization: After the arterial perfusion of 5-FU and MMC(solubilized with 0.9% sodium chrolide injection 20ml.),transcatheterarterial chmoembolization was performed simultaneously by CBP lOOmg and ADM or EADM 40mg mixed with ultra-liuified lipiodol about 10-20ml. The dose of lipiodol was decided by the size of diameter and blood supply paterns of HCC. The paterns were divided into four types including hypervasculor, hypovascular, mixed type and conspicuous arteriovenous shunt. The millitre number of lipiodol was approximately equal to the diameter centimeter number of the tumor multiplying 2 in hypervascular type, and in hypovascular and mixed type multiplying about 0.5 and 1. Conspicuous arteriovenous shunt was embolized with gelfoam granules, ?portal vein chemotherapy: If the arterial chemoembolization was unnecessary according to their arterial angiographic features of CT, the druags of 5-FU 1.0g, MMC 1 Omg, ADM 20mg or EADM 40 mg, CBP 1 OOmg solubilized with 0.9% sodium chrolide injection 50ml were dript or perfused into portal vein through DDS. If the TACE was necessary, 2/3 of the drugs were mixed with ultra-liquified lipiodol were used and 1/3 of them were used for PVC simutaneously. ?Chemotherapy permission: Liver function was normal and WBC were above 4.0 10/L. ?therapy procedure: PVC was performed through DDS once a month and its duration had been for 2 years. The time and the dose of TACE were decided by their interhepatic angiographic feature of lipoidol oil. The intervals were from 15 to 60 days and their procedures were 3 or 4 times unequally.?surveyed indexes:The survival ratio(Kaplan-Meier method , SPSS 10.0 software),the sequential resection ratio, the largest dimension of the lesions,the changes of AFP, the liver function, the serum liver fibrosis indexes and theropeutic complications. Results: The survival ratio of the therapeutic group was significantly high than that of the control group(P<0.05). the sequential resection ratio was clearly higher in theropiutic group(27.78%) than contral group (6.69%),( X2=4.902, P <0.05). Before and after TACE, the largest dimension of the lesions were 6.4±2.1(cm) and 5.6±1.9(cm) in control group (t=4.382, P<0.05),but they were 6.8±2.6(cm) and 5.4±1.2(cm) in theropeutic group(t=7.000, P<0.05) which showed more significantly diminutive than...
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