The Therapeutic Efficacy Of Tace For Hepatic Carcinoma And Its Influence On Hepatic Function

ObjectiveTranscatheter chemoembolization(TACE) improves survival in patients with hepatocellular carcinoma.The optimal schedule and repeated times,best anticancer agent and embolization are still unknown,and also there is no consensense on the effect of preoperative TACE for resectable large HCC.The purpose of this study is to evaluate the therapeutic efficacy of TACE for hepatic carcinoma and its influence on hepatic function.Material1.A retrospective collection from March 2000 to March 2008,92 patients (74 men,18 women;median age,52 years;age range,23-84 years) with HCC and 23 patients(17 men,6 women; median age,54 years;age range,31-73 years) with metastatic liver cancer (MLC) underwent TACE in our hospital . Methods1. Patients with HCC were divided into three teams depending on TACE sessions (Team 1:1-2 sessions, Team 2:3-4 sessions, Team3 :≥5 sessions),patients with MLC is Team 4.2. The therapeutic efficacy was assessed depending on survival rate,imaging response and biologic response (AFP). Hepatic function was evaluated according to some hepatic parameters(ALT,AST,ALB,DB,TB,PT).3. All date were expressed as means values±SD and analysised with SPSS 11.0. Differences were considered significant if the P value was less than 0.05 ,using an unpaired Student's t test or a chi-square tset .ResultsAll four teams'response rate were 4.3%,23.1%, 31.6%,and 17.3%,respectively.Liver function in Team 1 and Team 2 returns to its pretreatment level,but in Team 3 , Liver function can not returns to its pretreatment level thoroughly associated with more repeated TACE sessions. The 1-,2- and 3-year survival rate of Team 1 were 27.0%,10.8%,5.4%, respectively. The 1-,2- and 3-year survival rate of Team 2 were 57.1%,33.3%,19.0%, respectively , which were not significantly different from those of Team 3 ,62.5%,37.5%,18.8%. The median survival time of Team 4 is 11.1 months.ConclusionTranscatheter arterial chemoembolization is an effective palliative treatment that prolongs survival of patients with unresectable hepatocellular carcinoma or metastatic liver cancer.(1).3 to 4 repeated times of TACE is an effective palliative treatment that prolongs survival of patients with HCC,while 1 to 2 repeated times have only limited benefit.(2).Irreversible hepatic impairment induced by TAEC could offset its therapeutic efficacy partially,which has little benefit on improving survival of patients further.(3).TAEC is a useful method to improve survival of patients with metastatic liver cancer.