The Safety And Clinical Efficacy On GSMs-TACE Combined With PSE Treatment Of Primary Hepatocellular Carcinoma Of Hypersplenism

Objective: To evaluate the safety and efficacy of transcatheter arterial chemoembolization(TACE)used Gelatin sponge microparticles,GSMs as alone embolic agent combined with partial splenic embolization(PSE)in the treatment of primary hepatocellular carcinoma(PHC)complicated with hypersplenism.Methods: from January 2013 December-2017 Zhongshan Hospital Affiliated of Dalian University and Beijing Tsinghua Chang Gung hospital met the inclusion criteria of 64 cases of HCC complicated with hypersplenism were divided into two groups,34 patients with synchronous GSMs-TACE+PSE treatment as group PSE,30 patients at the same time as pure GSMs-TACE treatment as group TACE.The two groups were collected before and after operation of 4 days and 30 days of tumor markers(AFP),biochemical examination of blood routine,liver and kidney function,scan and enhanced scan for 4 days,30 days postoperative abdominal CT or MRI,according to mRECIST solid tumor evaluation standard of curative effect evaluation 1 months after the operation,Postoperative safety was assessed by the common adverse event evaluation criteria(CTCAE4.03).Results: two groups of patients underwent interventional operation succeed.All the two groups were observed abdominal CT at 4 days postoperatively.The focal necrosis of liver in the two groups was significantly reduced,while the AFP values were reduced.PSE group had a partial necrosis of the spleen after operation.During the group PSE were treated by GSMs-TACE for 98 times and 68 times of PSE treatment,4 days after the operation,1 of white cells and platelets than PSE before surgery increased in different degree,the difference was statistically significant(P < 0.05),the change of red blood cell count is not obvious,the difference was not statistically significant(P> 0.05).Group TACE were treated by GSMs-TACE for 87 times,4 days after operation,1 months,the number of red blood cell and platelet cells were no significant change,the difference was not statistically significant(P>0.05).No severe complications such as hepatorenal failure or splenic abscess occurred in the two groups.In group PSE,there were 3 cases of CR,26 cases of PR,4cases of SD and 1cases of PD;In group TACE,there were 2 cases of CR,23 cases of PR,4cases of SD and 1cases of PD.Conclusion: GSMs-TACE combined with PSE in the treatment of hepatocellular carcinoma with hypersplenism has good safety and short-term efficacy.