Clinical Study Of Transcatheter Arterial Chemoembolization Combined With Microwave Ablation In The Treatment Of Large-sized Hepatic Cancer

Objective: To evaluate the short-term efficacy and safety of transcatheter arterial chemoembolization in combination with microwave ablation for large-sized hepatic cancer.Methods: 68 cases collected from Qingdao University Hospital from January 1,2013 to November 30,2014 treatment of large hepatocellular carcinoma,including 61 males and7 females,aged 38 to 74 years.According to the different treatment methods,divided into the combined group(36 cases)and the control group(32 cases).Combined group 1 ~ 2times after TACE treatment 2 ~ 4 weeks combined with MWA treatment,the control group more than 2 times TACE treatment.In the two groups,31 patients(86.1%)and 26patients(81.3%)were positive for AFP.1 month,3 months,6 months after the review,and then every 3 to 6 months review,Including CE-CT,CE-MRI,liver function,alpha-fetoprotein(AFP),Observe the tumor size,necrosis and whether the recurrence,metastasis and so on.After 1 month of treatment,the short-term efficacy of the two groups was evaluated according to the imaging examination.the incidence of adverse events and complications,the number of treatment and the survival time of the patients were recorded and analyzed by statistical software.Results: No significant differences existed between both groups concerning age,sex ratio,Child-Pugh grade,number of lesions,maximum length and positive rate of AFP(P>0.05).Combination group and control group were treated with average 3.6 ±1.2 and4.9±1.8 times,respectively,and significant differences existed(P<0.05).There were 20 CR cases(55.6%),10 PR cases(27.8%),2 SD cases(5.6%),4 PD cases(11.1%)and 30 RR cases(83.3%)in combined group,while 8 CR cases(25%),8 PR cases(25%),4 SD cases(12.5%),12 PD cases(37.5%)and 16 RR cases(50%)for control group.The complete remission rate(CR),disease control rate(RR)and postoperative AFP conversion rate of the combined group were significantly better than the control group(P<0.05).The survival time of the combined group and the control group were 17.5 ± 6.32 months and 13.25 ± 6.73 months respectively,the difference was statistically significant(P <0.05).The median survival time of the combined group and the control group was 19 months and 12 months respectively,the difference was statistically significant(P <0.05).The survival rate at 12,18 and 24 months for combination group was better than that of the control group(P<0.05).The incidence of pain in the shoulder scapular and liver area was significantly higher than that in the control group(P <0.05),There was no significant difference in the incidence of Fever and other adverse reactions and serious complications between the two groups(P> 0.05)?There were no cases of intraoperative death in both groups.Conclusion: Transcatheter arterial chemoembolization in combination with microwave ablation is an effective therapeutic strategy for the treatment of large-sized hepatic cancer with reduced operation frequencies,less trauma,definite short-term efficacy and high safety,herein it would be great valuable for the clinical promotion.