Clinical Review Of The Curative Effect Of Transhepatical Arterial Chemoembolization Combined With Microwave Ablation In Treatment Of Intermediate And Advanced Heptical Carcinoma

Objective:To retrospectively evaluate the clinical effects and safety of trans arterial chemoembolization (TACE) or combination of TACE with microwave ablation (MWA) on advanced primary liver cancer.Methods:137 of cases with advanced liver cancer from Guangxi Medical School affiliated Tumor hospital between September 2010 and November 2012 were enrolled and retrospectively analyzed in this study. Among them,75 of cases treated with TACE-MWA were grouped as experimental group,62 of cases treated TACE were grouped as control group. The condition of patients from two groups were comparable (p>0.05). Each treatment cycle contained once TACE and once MWA for patients in experimental group or twice TACE for patients in control group. The post-operative adverse reactions including the damage of liver function, fever, gastrointestinal tract reactions and pain were observed and recoded. In addition, the short-term effect (after one treatment cycle), tumor size/volume and long-term effect such as survival time were also observed and recorded to evaluate the clinical effect and safety of TACE-MWA on advanced liver cancers.Results:After treatment, the clinical symptoms and quality of survival were improved for patients from both experimental group and control group. (1) After one treatment cycle, the effect and safety were evaluated using enhanced liver CT scans and colour doppler ultrasound. The effective rate of experimental group was 70.66%(CR+PR, CR=13, PR=40), the effective rate of control group was 41.93%(CR+PR, CR=4, PR=22). The difference between two groups is significant (p<0.05). (2) The survival rate post 3,6,12,24 months were 100%, 100%,92% and 61.33% for experimental group or 98.38%,95.16%,82.25% and 35.48% for control group. There is no significant difference in survival rate post 3 and 6 months between two groups, while there is significant difference in survival rate post 12 and 24 months between two groups. (3) Transitional liver function damage, fever, pain and gastrointestinal tract reactions were main adverse reactions. No serious adverse reactions such as necrotic gallbladder, liver failure, traumatic liver rupture, liver abscess and death were observed in either group. After 5-7 days of liver-protection and symptomatic treatment, damage of liver function was improved. The pain was more frequently observed in experimental group. There is no significant difference in frequency of fever and gastrointestinal tract reactions between two groups.Conclusion:TACE-MWA which can effectively treat advanced liver cancers, prolong the survival, and has no significant adverse effects is more effective than TACE alone treatment. It will be a relatively effective and safe treatment for liver cancers.