The Clinical Efficacy Of Lipiodol-Arsenic Trioxide Emulsion Embolization In The Treatment Of Primary Hepatic Carcinoma

Object:To analysis the clinical efficacy and toxicity of lipiodol-arsenic trioxide emulsion in the treatment of primary hepatic carcinoma via transarterial chemoembolization.Methods:The clinical date of 145 primary hepatic carcinoma patients with advanced or early which do not want surgical treatment and A or B of Child-Pugh class liver function in the Department of Interventional Radiology,the First Affiliated Hospital of Southwest Medical University were retrospectively analyzed,according to lipiodol emulsifying drug were randomly divided into three groups : lipiodol-As₂O₃ emulsion（Group A n=47）,lipiodol-doxorubicin emulsion（Group B n=48）,lipiodol alone（Group C n=50）.Three groups were in the surgery after chemotherapy drugs oxaliplatin and mitomycin which embolised with lipiodol emulsion,and according to the situation of embolization added an appropriate amount of gelatin sponge particles or PVA.Adverse reactions were observed in patients,and to be routine liver treatment.The second treatment after the first treatment 4-6 weeks.Blood routine examination,liver and kidney function,AFP and liver CT examination were reviewed two monthly.According to test results which decided the next treatment time.Overallsurvival,survival time,time to progression,clinical response rate,disease control rate,side effects and safety were observed,which observation and treatment effect we followed up over 1year.Results:The recent clinical response rate,disease control rate,median,survival rates in 6,12,18,24 month,time to progression in Group A（lipiodol-As₂O₃ emulsion）were59.6%,93.6%,30 months,91.7%,76.6%,65.3%,48.1%,18 months respectively;in Group B（lipiodol-doxorubicin emulsion）were 41.7%,79.2%,26 months,91.7%,76.6%,65.3%,48.1%,14 months respectively;in Group C（lipiodol alone）were 40.0%,72.0%,25 months,88.0%,75.3%,62.1%,42.2%,12 months respectively（P<0.05）.Multivariate analysis showed that the different regimens,portal vein tumour thrombosis（PVTT）,Child-Pugh class,size of PHC,AFP and the treatment times of TACE were independent prognostic factors.And the treatment times of TACE as a protective factor.The major toxic and side effects were nausea,vomit,hepatalgia,fever,myelosuppression and hepatic function damage.After the positive treatment,these symptoms were relieved or disappeared.No irreversible poisoning and side effects occurred.Conclusion:Lipiodol-arsenic trioxide emulsion injection via hepatic artery by cathetersis is an effective in the treatment of primary hepatic carcinoma,which can improve the 1-year,2-year survival rate of patients,prolong survival time and there is no obvious destruction to the cardiac,liver and kidney function.It`s effective and low-toxicity.