| Objective To evaluate the clinical effect and application value of transarterial chemoembolization(TACE) combined with microwave ablation (MWA) therapy and percutaneous ethanol injection (PEI)in large liver carcinoma.Methods Analysis of 80 patients with large liver cancer received TACE,MWA and PEI in Haikou people's hospital from August 2005 to August 2010.40 patients were treated with MWA and PEI were enrolled in control group,40 patients were treated with TACE combined with MWA and PEI were enrolled in test group. The test group patients were performed firstly in TACE treatment. After 2-4 weeks, accept the PEI and MWA treatment. First, alcohol injection in tumors, until alcohol fully dispersion to treatment with MWA. Therapeutic purposes is cover 5mm-10mm normal liver tissue around the tumor, after complete MWA therapy, treatment the insurance area with PEI and (or) MWA again. The control group were 93 tumors, A total of 87 times MWA treatment,109 times PEI treatment, the test group were 93 tumors, A total of 63 times TACE treatment,76 times MWA treatment,92 times PEI treatment. After one-month treatment, Comparing the two groups of patients on liver function, blood AFP variations before and after the treatment; judgment the tumors necrosis, recurrence and metastatic state of cases With contrast-enhanced ultrasonography and contrast-enhanced CT/MRI results after treatment, follow-up survival period,survival rate and complications, Survival analysis technique analyze of survival rate.Results①ll the patients was with some degree of remission after one-month treatment, All the patients was in a good condition. They showed relief or disappearance of symptoms, significant increase in appetite, improvement in liver function, and enhance quality of life.②The overall response rates were 87.5% and 67.5% in the test group and the control group,respectively (P＜0.05).③The average reduced rates of AFP was 71.7% and 41.2% in the test group and the control group, respectively (P<0.05).④0.5 years,1 year,2 years,3 years,4 years of accumulated recurrence and metastasis rate were 7.5%,12.5%,30.0%, 52.5%,57.5%and 20.0%,27.5%.57.5%,72.5%,85.0% in the test group and the control group, there was no significant difference between the two groups (P>0.05), but the test group can delay relapse and metastasis peak hours.⑤The median survival time and 0.5 years,1 year,2 years,3 years,4 years,5 years accumulate survival rate were 45 months,94.4%, 88.9%,83%,63.8%,42.5%,8.9%and 24 months,85.0%,87.5%, 48.8%,29.3%,9.8%,0 in the test group and control group, respectively (P＜0.05).⑥he side effects of two groups were similar and the serious complications were not found. There was no significant differences between the two groups in the adverse effects (P>0.05).Conclusions①ACE combined with MWA and PEI therapy in large liver carcinoma better than MWA combined with PEI therapy:the overall ablation rate,AFP rate of descent,delay relapse and metastasis time,prolong the survival duration and improve survival.②ombined with TACE treated can raise curative effect, to hold the indication strictly, don't increase toxic and side effects.
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