Mid-term Assessment Of The Liver Function After TACE Combined With Targeted Therapy And Immunotherapy And Alone

Background and Objective:Hepatocellular carcinoma is the sixth most common cancer worldwide.Intermediate-stage hepatocellular carcinoma is highly heterogeneous in terms of tumor burden and liver function,leaving it open to further consideration in the choice of treatment options.The aim of this study was to observe the changes of liver function within the mid-term period after TACE combined with targeted therapy and immunotherapy and TACE alone for hepatocellular carcinoma.Materials and Methods:We retrospectively analyzed the clinical data of 44 patients with intermediatestage hepatocellular carcinoma（CNLC Ⅱb、Ⅲa）admitted to interventional department of our hospital from January 2019 to July 2021,including 38 males and 6 females,aged 40-79 years,with an average age of 57.75 ± 10.051 years.44 patients with intermediate-stage hepatocellular carcinoma underwent preoperative routine electrocardiogram,liver CT,MRI and other related examinations to exclude contraindications to surgery.According to the different treatment plans,44 patients were divided into the combined group（TACE combined with targeted treatment and immunotherapy,19 patients）and single group（TACE alone,25 patients）.Parameters and grades related to liver function before the first TACE treatment,3 months and 6months after the first TACE treatment were compared and analyzed between the two groups,including ALT,AST,CHE,TB,ALB and PALB,CP and MCP grade,ALBI grade,MELD grade,NLR,LMR,PLR,ALRI etc.Results:There was no difference in parameters related to liver function between the two groups before TACE（P>0.05）.There was no difference in parameters related to liver function in the TACE group at 3 and 6 months compared with preoperatively（P>0.05）.Comparison of the combined group at 3 months postoperatively and preoperatively: PALB increased（P < 0.05）,LMR increased（P < 0.05）,and PLR decreased（P < 0.01）;the difference in NLR and PLR between groups was statistically significant（P < 0.05）.Comparison of the combined group at 6 months postoperatively and preoperatively: AST decreased,LMR increased,MCP grade decreased（P<0.05）,and the difference between groups was not statistically significant（P > 0.05）.Conclusion:When comparing TACE combined with targeted therapy and immunotherapy with TACE alone for primary hepatocellular carcinoma,both had no adverse effects on liver function within 6 months postoperatively.TACE combined with targeted therapy and immunotherapy had an improvement in liver function,mainly in terms of elevated PALB,lower AST,and lower MCP grade.Inflammatory parameters are important for the assessment of liver function.