Prognosis Factors Analysis Of Tace Combined With ¹²⁵i Seed Permanent Implantation In Treatment Of Hepatic Carcinoma

BackgroundPHC (Primary Hepatic Carcinoma)is one of the most common malignancies in China,which is a great threat to human health. The mortality has been reported to be the second in China. Transcatheter arterial chemoembolization (TACE) is a relatively new non-surgical treatment from 1980s. TACE combined with 125I seed PI(permenant implantation, PI) is an effective therapy for PHC,which can be regarded as the ideal alternative therapies for patients who have failed to respond to TACE alone. It has been reported effective rate of TACE combined with 125I seed PI is 66%-71%.This local treatment is particularly useful for killing the non-surgical liver tumors, the micro-metastases in lymph nodes and so on. TACE combined with 125I seed PI is a minimally-invasive technique with less sufferings and fewer complications,which can markedly improve the effect,and is expected to improve PHC prognosis.TACE combined with 125I seed PI has been shown to prolong survival in some patients with PHC,which can be counted to be improving the quality of life of hepatic cancer. Therefore,improving the overall prognosis after TACE combined with 125I seed permanent implantation is very important. It is important as well as the research work to analyze the prognositie factors for PHC patients after TACE combined with 125I seed permanent implantation. ObjectivesThrough research and discussion in survival rates and prognostic factors of TACE combined with 125I seed PI for treatment of hepatic carcinoma, including age,sex,ALT,AFP,HbsAg,Liver function,tumor size,tumor number,tumor metastasis,tumor pattern,portal vein tumor thrombus,TACE number,125I seed number and so on. Optimizing the impact of prognostic factors in patients for clinical treatment of hepatic carcinoma, in order to provide reasonable and effective basis for further optimization of TACE combined with 125I seed PI.MethodsRetrospectively analyzed the clinical data of 117 PHC patients were treated with TACE combined with 125I seed PI in Shandong Medical Imaging Researching Institute from 2005.05 to 2010.05. Filter 14 may be related with the survival factors, univariate and multivariate analysis. Using Kaplan-Meier method and Log-rank, method tests for univariate analysis, using Cox proportional hazards model for multivariate analysis.Results1.The cumulative survival rates of TACE combined with 125I seed PI for PHC at 1,2, 3 and 5year were 86.2%,54.3%,23.9% and 6.9% respectively.2.Single factor analysis show ALT, liver function, tumor pattern, tumor metastasis, tumor size and number, TACE number and portal vein tumor thrombus were found significant for surviva. Multi-variate Cox proportional hazards model show liver function, portal vein tumor thrombus and tumor number were gained statistical significant.Conclusions1.Liver function, portal vein tumor thrombus and tumor number were the major prognostic factors of TACE combined with 125I seed permanent implantation.2.Before the treatment of TACE combined with 125I seed implantation, supportive care can improve liver function and general condition which is better to the prognosis of the patients. In the mean time, strict control of portal vein tumor thrombus, tumor number can play a positive role to the prognosis.