| Objective:To investigate the therapeutic effect of TACE combined with high intensity focused ultrasound in treating advanced stage hepatic carcinoma. Meanwhile, the other purpose of this study is to evaluate the effectiveness and safety of this treatment, and provide certain theoretical basis for the comprehensive treatment of advanced stage of hepatic carcinoma.Methods:Forty-seven patients suffering from advanced stage of hepatic carcinoma were randomly divided into two groups in this study from October2010to December2012. The patients in experimental group (n=25) were provided with TACE in combination with HIFU therapy and those in control group (n=22) received TACE treatment alone. The clinical effects would be observed and recorded in real time. After the extraction of peripheral venous blood, flow cytometry was used to detect the levels of T lymphocyte sublets and lactate dehydrogenase release assay was used to detect the activity of NK cell. Meanwhile, routine testing the changes of routine blood test, hepatic and renal function, blood clotting function and AFP. Observe and evaluate the radiographic changes of CT or MRI before and after the treatment. Adverse reaction were also observed and compared between these two groups.Results:After TACE combined with HIFU treatment, the clinical remission rate of the experimental group was84%(21/25), and the control group was63.6%(14/22),there was significant difference between both groups (P<0.05). AFP in both groups were decreased, but in the experimental group much lower than in control group (P<0.05). In the operation, airborne ultrasound showed that gray values increased in the treatment target area, and ultrasound contrast showed ischemia necrosis change in the tumor. CT or MRI scan showed that the ablation effect of the experimental group was significantly better than the control group. The improvement of the percentage of CD3+、CD4+cells and the ratio of CD4+/CD8+were better than in control group significantly (P<0.05). The6-,12-month survival rate were72%,59.1%and48%,31.8%, respectively (P<0.05). All cases had different degrees of side effect (discomfort over the liver, fever, rise of ALT, jaundice). One case of skin burn was observed in experimental group. In the general observation of ultrasound channel tissues, we found different levels of thermal injury in the layers of abdominal wall tissue and coagulation necrosis was founded in the tumor tissue of therapeutic target area.Conclusion:1. TACE combined with HIFU therapy can increase the treatment efficiency, improve the immune function, to a certain extent improved the patient’s quality of life and improved the patient’s survival rate. The overall curative effect of the experimental group was better than the control group.2. Compared with the control group, the experimental group did not increase the occurrence of complications or made them worse, which is a safe and effective method in the treatment of advanced stage hepatic carcinoma.3. In the general observation of ultrasound channel tissues and organs, we found different levels of thermal injury in the layers of abdominal wall tissue. The exact injury was not founded in the tissues and organs around the therapeutic target area, but coagulation necrosis was founded in the tumor tissue of therapeutic target area. |
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