Clinical Study Of Metastases Of Liver Embolized By Kelp Micro Gelation Compared With By Lipiodol Alone

Objective:To compare the clinical efficacy of transcatheter arterial chemoembolization(TACE) therapy for Metastases of liver embolized by kelp micro gelation(KMG)with that by Lipiodol alone.Methods:43 patients with Metastases of liver were divided into KMG group(n=20, TACE+KMG) and control group(n=23, TACE+ Lipiodol). Inclusion criteria: ○1 all patients with primary lesions have surgical resection; ○2through image and laboratory examination of metastatic liver cancer diagnosis, and treatment of TACE no other organ metastasis; ○3 liver function Child-Pugh grade A or B level; ○4 the first line of treatment in TACE; and no hepatic artery chemotherapy embolism contraindication; ○5 metastatic lesions less than or equal to 3.Selected kelp micro gelation group the patients were told to accept the kelp micro gelation chemoembolization therapy, and signed the informed consent. 20 patients in the KMG group were infused with oxaliplatin and epirubicin, and then kelp micro gelation were injected to the target vessels till it was occluded.23 patients in the control group were perfused with the same medicine, then injected Lipiodol until the blood flow interruption and the disappearance of tumor staining;Before and after TACE, patients’ liver function, responses of tumor, quality of life and the cumulative survival rates and complications related to chemoembolization were recorded and analyzed one by one between two groups.Results:There was no significant difference between control group and KMG group in clinical and pathological data. After TACE the decrease in tumor shrinkage of patients in group 1 were greater than those of patients in group 2(P<0.05).Two group patients had no adverse reaction and serious complications, included nausea, vomiting and fever, 18 cases of pain in patients with kelp micro gelation group, while the control group only 12 cases, but in the symptomatic treatment after gradually ease。The incidence rate of no significant difference(P>0.05). The number of kelp micro gelation group treated patients was significantly less than the patients in the control group, patients of two groups in 4 weeks after CT or MRI display, kelp micro gelation group patients in complete remission(CR) 1 cases, partial remission(PR) 9 cases, progression free(NC) in 8 cases, progression of disease(PD) in 2 cases,the total efficiency(CR+PR)was 50%, the rate was 90%(CR+PR+NC) benefit; Lipiodol group patients in complete remission(CR) 1 cases, partial remission(PR) 8 cases, progression free(NC)in 10 cases, progression of disease(PD) in 4 cases, the total effective rate was 39.1%(CR+PR), benefit rate(CR+PR+NC) was 82.6%; the postoperative imaging manifestations, two groups of patients with tumor size a change of 19 people, including 10 cases in KMG group(50%), 9 cases of the control group(39.1%). Comparing the two groups, there were statistically significant(P<0.05). Rate is higher than the pure lipiodol group survival in patients after kelp micro gelation group, The end of the 1 year of follow-up, patients in group KMG after 6 months and 12 months survival rates were 90% and 75%, the control group were 91.3% and 47.8%, there were statistically significant difference between the two groups in the cumulative survival rate(P<0.05).Conclusions:Kelp micro gelation group checks after interventional AFP and tumor size determination, and the survival rate of patients after treatment is better than that of pure iodized oil embolism agent,。The results show that kelp micro gelation microspheres embolization effect is stronger than that of Lipiodol, short-term therapeutic effect of lipiodol embolization, and kelp micro gelation as a new embolic material can enhance the synergy of chemotherapy drugs, after the degradation in the body by the kidneys, non-toxic side effects and adverse reactions, to prolong patient survival time, improve the quality of life at the same time.Embolization syndrome is kelp micro gelation embolization of major adverse reaction due to sodium alginate, effectively blocking the blood supply of ischemic pain, occurred in a relatively long time, the degree of relative weight, most need painkillers to ease, fever phenomenon is more obvious, but either heat or pain can be controlled, reported no serious complications and peri operation death cases. Therefore, TACE with use of the kelp micro gelation for embolizing Metastases of liver was more effective than that by iodized oil alone.and can improve the life quality and the short- term survival rates, and has good application prospect and important clinical value in use.