Evaluation Of Therapeutic Effects With Microspheres Embolization For Giant Hepatocellular Carcinoma

Objective To evaluate the clinical therapeutic effect with Microspheres embolization for giant of hepatocellular carcioma(HCC).Methods We performed a prospective study of 180 HCC patients needed for TACE,then randomly signed them into group M (embolized by microspheres alone), group L (embolized by lipiodol alone) and group M+L (embolized by microspheres combined with lipiodol).Transhepatic arterial chemoembolization (TACE) of group M was performed by 300～700μm microspheres.Group L selected lipiodol alone to embolize. While Group M+L were embolized by about 1/3-1/2 lipiodol of total embolized volue and then microspheres feeding individual tumor vessels. Stoped the procedure when caused terminal vessel blockade.Count up embolized volue and repeated times of each group.Before and after therapy,patients'liver function,serumα-fetoprotein level (AFP),responses of tumor,complications related to embolization and survive rates of 180 days and 360 days were analyzed among three groups .Results Tumor necrolysis rate of three groups respectively were 43.3%,36.7%and 56.7%;remained enhancement of three groups respectively were 46.3%,53.5% and 36.8%.The difference among the three groups were significantly(P<0.05). The positive response (CR+PR)of group M was 40.0%and disease control rate(DCR=CR+PR+SD) 73.3%. Survive rates of 180days and 360 days were 90.0% and 83.3%. While those of group L were 43.3%,76.7%,86.7%,75.0%and group M+L were 56.7%,88.3%,93.3%,86.7%. Significant difference of survival rates and total effective among group M+L and M ,M+L and L was found(P<0.0125). The PFS,( Progression-free survival)of group M was12.1±5.3 mon,group L 11.1±6.1 mon.group M+L 16.7±5.3mon(P<0.05).Total times of TACE were 527 and average repeated were 3.41±1.32,group M 2.87±0.52 times,group L 3.75±1.47 times,group M+L 2.31±1.04 times.Lipiodol volue per capita of group M+L was (9.73±5.56) ml,group L(16.45±7.62) ml,saving volume close to 50%,(P<0.05). At the same time, untoward effects of incidence and persis time such as febricity, nausea and vomit,Hepatic pain were more lower in group M+L(P<0.05).Conclution Embolization with microspheres can get longer and more effective treatment. TACE with microspheres and lipiodol for embolizing HCC was more effective than with microspheres or lipiodol alone.