The Experimental And Clinical Research Of Octreotide By Intra Ateria Infusion In Combination With Conventional TACE In Treatement Of Advanced Hepatocellular Carcinoma

Objective To investigate the therapy value and the mechanism of octreotide by intre-arteria infusion in combination with conventional TACE in treatment of advanced hepatocellular carcinoma(HCC).Method In current study, we prospectively randomed 40 patients into a treatment and placebo group.The two group were all treated with TACE, and the drug is that Treatment group:20 cases were treated with octreotide 0.4mg. 5FU 1000mg. MMC 10-14mg EPI 50mg combinated with lipiodol (10-20ml). placebo group : 5FU 1000mg. MMC 10mg EPI 50mg combinated with lipiodol (10-20ml). Detect the level of alphafetoprotein (AFP) vascular endothelial growth facor (VEGF) Hyaluronic Acid (HA), Type III Procollagen (PCIII), Collagen Type IV(C-IV), laminin(LN)of the all cases in one day before the therapy and in one month after the therapy .Mesure the diameter of the tumor and estimate the effect of the near future .The survival was described by Kaplan-merier chart ,and was ananlyzed with Long-rank test.Results: The median survival in the treatment group is 23 months, and 20months in the placebo group. The accumulative survival rate of 6 month, 1 year and 2 year are 100% 84.2% 36.9% ; 95% 78.5% 14% in the placebo group. And there was a significant different of the total survival in the two group with the Long-rank test, and the total survival of the treatment group was better than the placebo group(P<0.05). The tumor remained stable in 27 patients , and progressed in 7 patients. 6 patients showed a partial response. There was no incidence of severe side-effect (WHO grade 4).The level of alphafetoprotein (AFP) vascular endothelial growth facor (VEGF) Hyaluronic Acid (HA), Type III Procollagen (PCIII), Collagen Type IV(C-IV), laminin(LN)of the all cases between the day before the therapy and one month after the therapy existed significant different (P<0.05). The change between the two group had a significant different(P<0.05), and there was a significant elevate of the change in the placebo group.Conclusion: Compared with conventional TACE, octreotide combinated with TACE in the treatment of advanced HCC appears more beneficial and less side effects. And it can delay the heptic fibrosis and the vascularization.