The Effects Of TCM-based Arsenic Trioxide On VEGF And Clinical Efficacy Evaluation After Transcatheter Arterial Chemoembolizatiom In HCC

BackgroundHepatocellular carcinoma (HCC) is the fifth common malignant tumor in the word, about 50 million patients die from this disease each year, and it has become the third reason of cancer death, its incidence is still rising in the past ten years. The total number of liver cancer in China has become the first in the world, about 11 million people died of liver cancer each year. So HCC has become a serious health problem in China, liver cancer is still the focus of the study about prevention and treatment in cancer. Surgical treatment of liver cancer is still the main method in early stage. Transcatheter arterial chemoembolization(TACE) is considered as the first treatment in middle-later period of liver cancer, but its long-term efficacy is unsatisfactory, Its rate of 5-year survival is only 7% to 10%. Residual tumor, VEGF and the growth of blood vessal which is promoted by VEGF are important factors to reduce the curative effect of TACE. Because of ischemia and hypoxia residual tumor cells will promote the growth of new blood vessels after TACE. Vascular Endothelial Growth Factor(VEGF) is one of the strongest and most specific factor which can promote the growth of blood vessel and relates to the prognosis factor in tumour. Demonstrated by some studies, Arsenic Trioxide has certain therapeutical effect to HCC, and anti-angiogenic is an important antitumor mechanism of anti-tumor by Arsenic Trioxide(As2O3).ObjectivesThis subject draft to use TACE combine with As2O3 to Hepatocellular Carcinoma treatment, and observe the Effects of TCM-based Arsenic Trioxide on VEGF and clinical efficacy evaluation after Transcatheter arterial chemoembolizatiom in HCC.MethodsThe topic intend to select 30 liver cancer patients after transcatheter arterial chemoembolization, divide 30 cases into 2 groups randomly, treatment group (15 cases) and control group (15 cases). Treatment group people were treated with Arsenic trioxide (10mg, ivd, given at the 1-14 days after TACE), for 4 weeks successively. Control group were treated with physiological saline (placebo). The response rates, VEGF in serum, performance status, quality of life-liver cancer, long term effect and adverse response to drugs were observed before and after treatment.Result(1)The response rates (CR+PR) of the treatment were 33.4% and the response rates (CR+PR) of control group were 6.7%. The stable rates (CR+PR+SD) were 73.4% in the treatment group, the stable rates(CR+PR+SD) were 66.7% in the control group, no significant differences were detected among them(P>0.05). (2) Influence to vascular endothelial growth factor, on the day before TACE, 3-day after TACE,8-day after TACE,16-day after TACE, the vascular endothelial growth factor of treatment group were 114.68,209.99,243.00,282.17ug/ml. the vascular endothelial growth factor of control group were 114.68,209.99, 243.00,282.17ug/ml.The days after the TACE the vascular endothelial growth factor increased in two groups. No significant difference was detected among two groups on 3-day after TACE and 8-day after TACE(P>0.05). When 16-day after TACE, the VEGF in serum obviously decreased in treatment group, but the VEGF in serum still increased in control group, significant difference was detected among them(P<0.01). (3) In Quality of Life, there was no significant difference between treatment group and control group in performance status. In the physical functions and the scores of self-assessment the treatment group was better than the control group, significant difference was detected among them(P <0.05). (4)About long term effect, In the treatment group the median progression-free survival was 240.30 days and the 1-year survival was 80%, In the control group the median progression-free survival was 179.15 days and the 1-year survival was 46.7%, the treatment group were better than the control group on the two datas, but because of the small sample size, no significant difference was detected among them(P>0.05). (5)There was no serious accident of adverse response to drugs in two groups, there were no significant differences about the adverse response to drugs in two groups(P>0.05).CONCLUSION1. Combined with arsenic trioxide, would improve response rates (CR+PR) of the TACE in HCC.2. Combined with arsenic trioxide, would reduce vascular endothelial growth factor in serum after TACE.3. Combined with arsenic trioxide, there was no significant impact in performance status and Quality of Life between treatment group and control group.4. Combined with arsenic trioxide, would improve progression-free survival and 1-year survival of TACE.5. Arsenic Trioxide is safe to use, there was no serious adverse response to drugs in two groups, and it would not increase accident of adverse response to drugs after TACE.