Clinical Results Of Docetaxel-containing Regimen In The TACE Of Hepatocellular Carcinoma

Objeetive:To objectively evaluate the clinical curative effect and adverse reaction of Docetaxel on primary hepatic carcinoma by the comparison of the two group, docetaxel group and conventional therapy group. Exploring more effective and comprehensive interventional treatment plan. In order to improve the effect of the treatment of primary hepatic carcinoma and provide guidance for clinical treatment.Methods:Retrospectively analysis 177 patients of primary hepatic carcinoma in our hospital who have accepted TACE during 2009～2011 years.92 patients in the treated group and 85 patients in the control group. The treated group:Firstly, injected dexamethasone 10mg for the purpose of prevent allergic reaction. Secondly,the patients in the treated group were received 0.9% normal saline 100ml infusion with the docetaxel 60mg/m2.Thirdly, injecting mixture with the iodized oil 5～20ml and 5-fluorouracil 250mg until blood slow or iodized oil deposit thickness. The control group:The patients in the control group were received the chemotherapy therapy medieine in cluding epirubicin or piraubicin 40～60mg/m2, mutamycin 8mg/m2, cispltin 60 mg/m2. According to patient's condition selecting several chemotherapy medicine, then combined iodized oil 5～20ml. Collected and compared the short-term curative effect, the level of alpha fetal protein(AFP), the Karnofsky performance status(KPS), drug toxicity, clinical symptoms, et al. Compared median survival time, the mean survival time,6,12,18 months cumulative survivalrate. In the meantime compared intervention therapy before and after the function of liver and kidney, blood changes and after interventional therapy fever, vomiting, pain and so on adverse reaction. Datas were statistics and analysis by using SPSS software.Results:Of the 177 patients recruited,92 patients in the docetaxel group and 85 patients in the conventional therapy group, there was no statistically significant differences in sex, HBSAg(+) and liver function grades Child-pugh (A/B) between the two groups(P>0.05).Concerning short-term curative effect:In the docetaxel group, no patient attained complete remission(CR) and 26 partial remission(PR),the effective rate being 28.2%. In the conventional therapy group, no patient attained complete remission(CR) and 20 partial remission(PR), the effective rate being 21.7%. There was no significant statistic differences in the effective rate between the two groups(P>0.05). In the docetaxel group,83 patients attained CR and PR add stable disease(SD),the stability rate being 90.2%. In the conventional therapy group,68 patients attained CR and PR add stable disease(SD), the stability rate being 80.0%. There was no significant statistic differences in the stability rate between the two groups(P>0.05).Before the treatment, in the docetaxel group, the level of AFP less than 20 ug/L was 10 patients,20 to 40 ug/L was 33patients, greater than 400 ug/L was 49patients.In the conventional therapy group, the level of AFP less than 20 ug/L was 9 patients,20 to 40 ug/L was 31 patients, greater than 400 ug/L was 44 patients. In two groups after treatment ,AFP decline 50% was 34 and 25 patients respectively.There was no significant statistic differences on AFP value rates to pre-operation between the two groups (P>0.05). There was significant statistic difference on AFP value after treatment between the two groups. There was significant statistic difference on AFP value subtraction after treatment between the two groups (P<0.05).In the docetaxel group, the mean survival time, median survival time (MST),6,12,18,22months, cumulative survival rate was 14.1 months,14 months, 94.5%,48.9％,15.2%,5.4%respectively,while in the conventional therapy group was 12.6months,12 months,91.7%,37.6%,7.0%,Orespectively. There was no significant statistic differences in 6 months survival rate between the two groups(P> 0.05).Opposite, There was·significant statistic difference in 12,18,22months survival rate between the two groups(P<0.05). There was significant difference accumulative survival rate between the two groups(P<0.05).One month after treatment the patients in the two groups had arise in KPS compared with the pre-operatio(P<0.05). In the same time,there was significant statistic difference in KPS between the two groups (P<0.05).Concerning hematological toxicity:There was decrease in hemoglobin (Hb) compared to the pre-operation(P<0.05) of patients in both two groups. There was no significant statistic change in hemoglobin (Hb) between the two groups(P>0.05). There was decrease in white blood cell (WBC) compared with the pre-operatio(P< 0.05). There was no significant change in white blood cell (WBC) between the two groups(P> 0.05).The patients in both two groups showed similar decrease in platelet(PLT), there was significant statistic difference in platelet(PLT)between the two groups(P< 0.05).In two groups, the patients in AST,ALT and TBIL all increase compared with the pre-operation(P<0.05),there was no significant difference in AST,ALT and TBIL between the two groups (P>0.05). In two groups,there was no significant difference in ALB compared with the pre-operatio (P>0.05).Concerning renal function:In the docetaxel group, there was no obviously change on serum creatinine(Cr) and blood urea nitrogen(BUN) compared with the pre-operatio(P>0.05). In the conventional therapy group, there was no obviously change on blood urea nitrogen(BUN) compared with the pre-operatio(P>0.05),but there was significant statistic on serum creatinine(Cr) compared with the pre-operatio(P<0.05).In the docetaxel group after interventional,9(9.7%) patients had nausea and 11(11.9%) patients had fever, but for the most part in 2 to 4 days disappear. In the conventional therapy group,19(22.3%) patients had nausea and 25(29.4%) patients had fever. There was significant statistic difference on nausea and fever between the two groups. (P<0.05)Conclusions:1. The docetaxel -containing regimen treatment of primary liver cancer be able to effective improve curative effect and it's advantage to conventional therapy inhibition and kill hepatocarcinoma.2. The docetaxel -containing regimen selective arterial embolization of liver cancer more efficiently improve short-term survival quality compared to conventional therapy,and it's advantage to a certain degree extent lengthen patient survival time.3. The docetaxel -containing regimen selective arterial embolization of liver cancer minimal damage to the gastrointestinal tract and renal function compared with conventional therapy.In the same time ,improve the patient's tolerance and safety.