Comparative Study Of Efficacies Of Tace Combined With¹²⁵I Seed And Of Sample TACE In Treatment Of PLC

Primary liver cancer （PLC） is the most common primary malignancy inlivers,each year about250thousand new cases of the liver cancer have beendiagnosed in the world, of which45%occurred in China, every year100¹30thousand Chinese die from liver cancer, of which hepatocelluar carcinoma （HCC）accounting for about90%. The disease has an insidious onset, and lacks typicalsymptoms in early stage, the majority is associated with chronic hepatitis,84%ofthe patients are associated with cirrhosis, with the high degree of malignancy andbad prognosis, operative removal is still the preferred method of treatment.However, because most patients have already entered the middle and advancedstage of the cancer when being diagnosed, only10%¹5%of them can receivethe operative removal. Transcatheter Arterial Chemoembolization （TACE） is thepreferred treatment method for unresectable hepatocellular carcinoma. Forunresectable hepatocellular carcinoma, TACE can control tumor growth andprolong survival and improve patients’ quality of life, and with fewercomplications. However, TACE has also flaw, namely only40%of the tumortissue shows complete necrosis after the treatment. Due to the bad long-termprognosis of TACE, combining other interventional treatment methods is oftennecessary, and radiation therapy is an important adjuvant therapy after TACEemerging in recent years.¹²⁵I radioactive seed implantation treatment for livercancer is of an internal radiotherapy, which can significantly reduce thecomplications of external radiotherapy, and compared with external radiotherapy,it has more advantages.Objective: To contrast the clinical efficacies of Transcatheter ArterialChemoembolization （TACE） combined with¹²⁵I radioactive seed implantation and of sample TACE in treatment of primary liver cancer.Method: To select152cases of patients diagnosed as primary liver cancerthrough laboratory tests, imaging studies and pathological diagnosis fromSeptember2003to March2012in our hospital. During the period30cases werelost to be followed for various reasons, and122cases were collected. Among them,80cases are of male patients,42cases are of female patients, their ages are29-78years, mean age is53.5years,15cases are in the left lobes of livers,61cases arein the right lobes,40cases are in both the left lobes and right lobes of the livers,6cases are in the caudate lobes.84patients were accompanied with hepatitis B,24patients were accompanied with hepatitis C, and70cases accompanied with livercirrhosis. The patients were divided into two groups, and a total of80patients ingroup A underwent sample TACE treatment. A total of42patients in group Breceived the TACE+¹²⁵I radioactive seed implantation. According to the primaryliver cancer staging standard revised by the HCC Professional Committee of theChinese Anti-Cancer Association in2001, among the patients,13cases were in Iastage,16cases were in Ib stage,25cases were in IIa stage,22cases were in IIbstage and46cases were in IIIa stage.93cases of hepatocellular carcinoma inmiddle and advanced stage accounted for76.2%. To determine the effect of thetreatments according to the Response Evaluation Criteria in Solid Tumors（RECIST） and the Response Evaluation Criteria in Specification of ComprehensiveInterventional Treatment for Liver Cancer, through reviewing the postoperativechanges in tumor sizes with CT and MRI, comparing the changes of liver functionbefore and after treatment as well as of survival rate of patients.Results: The postoperative review results of patients in group B with CTscan and MRI showed a local tumor control rate higher than patients in group A;the postoperative liver function of patients in group B showed a significantimprovement compared to their preoperative liver function with an improvementrate significantly higher than that of group A （p <0.05）; Compared with group A, Group B patients’one-year as well as two-year survival rates liver functionand median survival time improve, differences of statistical significance.Conclusion: To treat primary liver cancer with TACE+¹²⁵I seedimplantation in can overcome the deficiencies of sample TACE and achieve bettertumor local control, improve patients’ liver function, quality of life and one-yearas well as two-year survival rates and median survival time. This method is safe,minimally invasive, has fewer complications, thus it is an effective treatmentmethod for primary liver cancer. However, due to relatively small number of casesof TACE+¹²⁵I seed implantation, short follow-up time, tumor distant metastasisand other reasons in this study, patients’ long-term effect needs further observationand research.