The Clinical Study Of Thalidomide In Combination With TACE To Treat HCC

Objective To study the influence of thalidomide(TLD) in combination with transcatheter arterial chemoembolization(TACE) on Quality of life(QOL),the short-term outcome, time to progression(TTP),survival time and vascular growth factor expression, cellularimmunity function and the correlation between the serum vascular growth factor expression and the characteristic features of digital subtraction angiography in patients with hepatocellular carcinoma(HCC).Methods 29 cases of HCC were randomly divided into two groups. A group(n=17) receiveed thalidomide 200 mg daily for 8 weeks combinded with TACE, B group(n=12) was treated by TACE. Serum vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bFGF),Tumor necrosis factorα(TNF-α), alpha-fetoprotein(AFP) and cellularimmunity function were determined before and one month after TACE treatment. the scole of QOL and digital subtraction angiography(DSA) was evaluated at the same time.Results The short-term outcome was significantly different between A and B groups after therapices(P<0.05). the scole of QOL were significantly different between A and B groups after therapices(P<0.05), but it was not significantly different between A and B groups before treatment(P>0.05).The concentration of VEGF, TNF-αwere significantly different between A and B groups after therapices(P<0.05), but it was not significantly different between A and B groups before treatment(P>0.05). The concentration of bFGF was not significantly different between A and B groups before and after treatment(P>0.05).The number of NK and ration of CD4+/CD8+ of all HCC cases were lower before the therapices than those of the normal human beings(P<0.01), and it was not significantly different between A and B groups before treatment(P>0.05). The number of NK and ration of CD4+/CD8+ of A groups were enhanced after the therapices,and it was not significantly different than those of the normal human beings(P>0.05).But the number of NK and ration of CD4+/CD8+ of B groups were still lower after the therapices than those of the normal human beings(P<0.01).Significantly positive correlation was observed between the changes of VEGF and characteristic characteristic features of DSA(R=0.562, P=0.015<0.05),but there was no significantly correlation among the change of bFGF, TNF-αand characteristic features of DSA(P>0.05).Conclusion Thalidomide in combination with TACE inhibited the concentration of VEGF, TNF-α,improved the short-term outcome and the QOL of the patients with HCC. TACE might inhibite the celluar immunity function. Thalidomide might help enhace the cellular immunity of the patients with HCC.The change of serum VEGF after TACE might help judge the therapeutic efficacy of the patients with HCC.