The Clinical Study Of Treatment Of PVCE With TACE For Primary Hepatocellular Carcinoma With Portal Vein Tumor Thrombus

Objective:To investigate the treatment value of precutaneous transhepatic portal vein chemoembolization(PVCE)with transcatheter arterical chemoembolization(TACE)for primary hepatocellular carcinoma with portal vein tumor thrombus.Methods:From June 2004 to November 2006,48 cases of primary hepatocellular carcinoma with tumor thrombus in the portal vein,were divided into two groups,the treatment group which was treated with TACE+PVCE, and the control group was treated with TACE.The changes of AFP,portal vein,gastrointestinal symptoms(abdominal distention,nausea),and 1-year survival rates were analized respectively.Results 1.The changes of AFP of before and after treatment in the tow groups The treatment groupwere(1569±355)μg/Land(1507±320)μg/L,the control group were(1334±347)μg/L and(1319±104)μg/L,there was no changes in AFP concentration between the two groups. 2.The changes of the portal vein After treatment,in the treatment group①the portal vein diameter narrowing rate was 30.4%(7/23),②the rate of portal blood flow velocity expidation was 30.4%(7/23),③the reduce rate of PVTT was 43.5%(10/23);In the control group①the portal vein diameter narrowing rate was 12%(3/25),②the rate of portal blood flowvelocity expidation was 8%(2/25),③the reduce rate of PVTT was 12%(3/25).The treatment group in the portal vein diameter narrowing rate, portal blood flow velocity faster,and rate of portal vein tumor thrombus reduce rate were significantly higher(p＜0.05)than the control group.3.The changes of gastrointestinal symptoms improvement In the treatment group,the rate of gastrointestinal symptoms improvement was 70% (16/23);In the control group,the rate of gastrointestinal symptoms improvement was 28%(7/25).The treatment group in the gastrointestinal symptoms improvement was significantly higher(p＜0.05)than the control group.4.The changes of the 1-year survival rate After treatment,in the treatment group,the 1-year survival rate was 48%(11/23);in the control group,the 1-year survival rate was 28%(7/25).The changes of the 1-year survival rate of the treatment group was significantly higher(p＜0.05)than control.Conclusion The treatment of Portal vein embolization chemotherapy with transcatheter arterical chemoembolization for primary hepatocellular carcinoma with portal vein tumor thrombus can reduce the patients gastrointestinal symptomms,improve life quality,extend survival rate.The methods is simple,safe and can be repeated.