Transcatheter Arterial Chemoembolization Combined With Percutaneous Cryoablation For The Treatment Of Patients With Unresectable Large Hepatocellular Carcinoma:A Clinical Study

Objective:To discuss the cliical theyapeutic value of transcatheter arterial chemoembolization(TACE)combined with cryoablation(TACE-cryoablation)in treating the giant(main tumor?5cm in diameter)hepatocellular carcinomas(HCCs).Methods:A total of 90 patients with unresectable large hepatocellular carcinoma admitted to our hospital from January 2014 to January 2017 were selected as the research objects.They were divided into treatment group(TACE alone)and control group(TACE-cryoablation).The treatment group included 46 HCC patients and TACE combined with cryoablation was carried out.The control group had 44 HCC patients,who received TACE only.All the patients were followed up regularly.The clinical efficacy,adverse reactions and T lymphocyte subsets water before and after treatment were compared between the two groups.Results:During the follow-up period of 12-36 months,the survial rate at 1,2,3years in all patients was 65.6%,23.3%and 4.4%.The median survival time of the treatment group was 18.4 months,which was superior to that of the control group 12 months,The difference was statistically significant(P<0.05).One month after the first treatment,the objective response rate of the treatment group was 63%,which was superior to that of the control group 45.4%.The difference was statistically significant(P<0.05).The primary and secondary adverse reactions of the two groups were significant.There was no significant difference in the incidence(P>0.05).The incidence of adverse reactions in the treatment group was 23.90%,which was higher than that in the control group 15.9%.There was no significant difference in the incidence(P>0.05).Before treatment,There were no significant differences in CD3+,CD4+,CD8+,and CD4+/CD8+levels between the two groups(P>0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+in the two groups were higher than those before treatment,and the treatment group was higher than the control group,while the CD8+levels in the two groups were lower than before treatment,and the treatment group was lower than the control group.The difference was statistically significant(P<0.05).In the group of tumor diameter?10cm,the median survival time of the treatment group was 22.3 months,which was superior to that of the control group 12.3 months,The difference was statistically significant(P<0.05).In the group of tumor diameter>10cm,the median survival time of the treatment group was 12.4 months,The median survival time of the control group was 11.7 months,there was no significant difference.In the group of tumor with PVTT,the median survival time of the treatment group was 19.4 months,which was superior to that of the control group 14.8 months,The difference was statistically significant(P<0.05).In the group of tumor with PVTT(-),the median survival time of the treatment group was 12 months,The median survival time of the control group was 11.72months,there was no significant difference.Conclusions:TACE combined with cryoablation is effective in the treatment of unresectable large liver cancer,with less incidence of adverse reactions.It can effectively improve the cellular immune function of patients,which is worthy of clinical application.