Clinical Effect Of Transcatheter Arterial Chemoembolization Combined With Multipolar Radiofrequency Ablation For Advanced Liver Carcinoma

Objective To study the clinical effect of Transcatheter Arterial Chemoembolization(TACE) combined with Multipolar Radiofrequency Ablation for advanced livercarcinoma by ultrasound or CT guide。.Methods The retrospective analysis enrolled in48patients admitted to our hospitalbetween2011November and2013June, the patients were assigned randomly. Thestudy group had undergone TACE and RFA treatment in24patients, and the controlgroup with TACE only in another24patients. There were no statistically significantbetween two groups in general information and disease state.48cases with53lesions,the study group with26lesions had undergone TACE and RFA treatment by ultrasoundor CT guide, and the control group with27lesions was treated with TACE only. Twogroups of patients with liver cancer of AFP, lesions monitor, quality of life, pain andcomplications were observed after treatment to compare the clinical effect of twomethods and be stratified analysis. And48cases with complete datasets on clinicaltreatment procedures and follow-ups.Results In17cases of study group the AFP level was≥200μg/L per-treatment（70.8%）, after6months, in12of17cases the AFP level were in normal range（70.6%）; in4case（s23.7%）theAFP level reduced by66.3%on average, and in1case（5.8%）theAFP level increased by55.2%. In control group,2cases（11.8%）theAFPlevel were in normal range, in8cases（47.1%）the AFP level reduced by31.3%onaverage, and in7case（41.2%）the AFP level increased by61.3%on average.The difference was statistically significant in the two groups (P<0.05).6months later, all53lesions were examined by CT. In7lesions of the study group no tumor recurrence werefound（26.9%）.17lesions（65.4%）showed partial shrink with10lesions（38.5%）the shrinkage were≥50%and7lesions (26.9%)＜50%;2lesions（7.7%）was suspectedto be recurrence. The overall effectiveness rate was63.0%. Compared with the controlgroup, In3lesions without recurrence（11.1%）. In4lesions（14.8%）the shrinkage was≥50%and8lesions (29.6%)＜50%;12lesions（44.4%）were considered to berecurrence. The effectiveness rate was25.9%. The difference was statisticallysignificant in the two groups (P<0.05). After6months, the pain diabetes in study groupwas lower than those in control group. The liver function such as albumin, totalbilirubin, alanine aminotransferase in study group were improved than in control group.48cases that underwent TACE treatment had no serious complications. But thegastrointestinal reaction and the embolization syndrome, such as nausea, vomiting, fever,liver pain and other symptomatic were gradually eased within one week after supportivetreatment. In the procedure of RFA treatment,24patients suffered from liver pain.Serious complications such as bleeding occurred in1case, after24h′closed observationand the use of hemostatic drugs, the bleeding stopped.2cases had occurred gallbladderheart reflection, after atropine injection in time, no cardiovascular accident happened.Conclusion Interventional therapy is the more effective treatment strategy forunresectable advanced liver cancer. The combined treatment of TACE followed by RFAimproves the prognosis and survival quality of the patients, and worthy of furtherclinical applications.