| Objective:To investigate the effect of drug-eluting microsphere chemoembolization(deb-tace)and conventional transcatheter arterial chemoembolization(ctace)in the treatment of hepatocellular carcinoma(HCC),compare the effect of different treatment methods and the impact on the survival of patients,and analyze the factors affecting the prognosis of patients with hepatocellular carcinoma.Method:From January 2019 to March 2020,the interventional radiology department of Jingzhou central hospital was selected to accept transcatheter arterial chemoembolization(TACE)for the first time Methods: Forty one patients with hepatocellular carcinoma(HCC)treated with TACE(chemotherapy,TACE)were enrolled in this study.The baseline information of the patients was recorded in detail,and the related imaging and laboratory examination,BCLC staging and other preoperative evaluation work were improved.According to the treatment plan,24 patients in the control group were embolized with iodized oil,while 17 patients in the experimental group were treated with deb-tace,using domestic callispheres microspheres.The patients were followed up for 1year to evaluate the treatment effect at different time points of 1 month,3 months,6months and 12 months after operation;the safety indexes included physical status,liver and renal function,post embolism syndrome and serious adverse reaction events.The clinical data of the patients were collected and the prognostic factors were analyzed.Result:(1)There was no significant difference in Okuda stage,Barcelona liver cancer stage,gender composition,clinical characteristics distribution,tumor load,portal vein tumor thrombus or metastasis,and child Pugh grade between the two groups(P > 0.05).(2)1 month after operation,Orr and DCR of the experimental group were 76.47%and 94.12%,while those of the control group were 58.33% and 79.17%,respectively.There was no statistical significance between the two groups(x2 values were 1.455 and1.780,P > 0.05).Three months after operation,the Orr and DCR of the experimental group were 52.94% and 76.47% respectively,while those of the control group were 45.83%and 75.00%,respectively(x2 values were 0.201 and 0.011,respectively,P > 0.05);the 6-month follow-up showed that the Orr and DCR of the experimental group were 29.41%and 64.71% respectively,while those of the control group were 25.00% and 62.50%,respectively.There was no statistical significance between the two groups(x2 values were0.098,0.020,P > 0.05).The 12-month follow-up showed that the orr of the experimental group was 11.76%,DCR was 41.18%,and the orr of the control group was 12.50% and DCR after treatment There was no significant difference between the two groups(x2 =0.005,0.056,P > 0.05).(3)During the treatment,1 case of gastrointestinal bleeding and 1 case of bile leakage complicated with infection occurred in the experimental group,and the incidence of serious adverse reactions was 11.76%;in the control group,1 case of tumor rupture bleeding,3 cases of liver and renal failure,2 cases of gastrointestinal bleeding,2 cases of bone marrow suppression,3 cases of bile leakage complicated with infection occurred,41.67%;the experimental group was lower than the control group,and the difference was statistically significant(P < 0.05)5).During the treatment,no cardiotoxicity,abdominal hemorrhage and liver abscess occurred in the two groups.(4)This study showed that the incidence of adverse reactions such as body temperature > 38 ℃,local bile duct injury,fatigue,nausea and vomiting,abdominal pain in the experimental group were lower than those in the control group,with statistical significance(P < 0.05);see Table 3 for details.Both groups had mild symptoms,which were cured after symptomatic treatment and did not affect the treatment.(5)There was no significant difference in liver function(ALB,TBIL,AST,ALT)between the two groups before operation(P < 0.05).Data comparison between the two groups,ALB,TBIL,AST,ALT in the experimental group at 1 month and 3 months after operation compared with the control group,the difference was statistically significant(P< 0.05);ast,ALT in the experimental group at 6 months after operation was lower than that in the control group,the difference was statistically significant(P > 0.05);there was no statistical significance between the two groups at 12 months after operation(P > 0.05).(6)There was no significant difference in ECOG-ps score between the two groups before operation(P > 0.05);ECOG-ps score of experimental group was lower than that of control group at 1 month,3 months,6 months and 12 months after operation(P < 0.05).(7)In this group,41 patients were followed up for 1 year,41 cases were successfully followed up,the success rate of follow-up was 100%;to the end of followup,31 cases of HCC patients survived,the survival rate was 75.61%;10 cases died,the mortality rate was 24.39%.The DFS was 3-12 months(8.15 ± 2.06)months.(8)Gender,age,AFP level,ascites,cirrhosis,distant metastasis,arteriovenous fistula,portal vein tumor thrombus,liver child Pugh classification,Barcelona liver cancer stage,TACE treatment plan,tumor diameter,tumor number were set as independent variables.Univariate analysis showed that there were distal metastasis,arteriovenous fistula and portal vein Tumor thrombus,liver child Pugh grade B,Barcelona liver cancer stage,tumor diameter,tumor number,AFP > 400 μ g / L were the influencing factors of prognosis of HCC patients(P < 0.05).(9)Multivariate analysis showed that AFP > 400 μ g,Barcelona liver cancer stage,tumor diameter > 5cm were independent risk factors for HCC prognosis(P < 0.01).Multiple tumors,child Pugh classification,arteriovenous fistula and distal metastasis were moderately correlated with the prognosis of HCC(P > 0.05),while portal vein tumor thrombus was weakly correlated with or not correlated with the prognosis of HCC(P >0.05).Conclusion(1)Tace-tace was more effective than TACE in the treatment of HCC.(2)Deb-tace regimen is safe for HCC,does not increase the incidence of post embolism syndrome,and has less serious adverse reactions.(3)Compared with the ctace regimen,deb-tace can improve the liver function of HCC patients in the short-term after operation,and the long-term effect on liver function is low.(4)The application of deb-tace regimen in patients with HCC is helpful to improve their physical status.(5)Multivariate analysis showed that AFP > 400 μ g,liver cancer stage in Barcelona and tumor diameter > 5cm were the risk factors affecting the prognosis of HCC patients. |
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