Transcatheter Arterial Chemoembolization Combined With Argon-helium Cryosurgery System For The Treatment Of Advanced Primary Liver Cancer

Objective:Primary liver cancer is one of the most common malignant tumors in the world.There are 626,000 new cases every year.The vast majority of patients are hepatocellular carcinoma,accounting for 85%-90% of all pathological types.Liver cancer has a high degree of malignancy and rapid growth.The patient is generally asymptomatic.At the time of diagnosis,he or she has developed advanced metastasis or distant metastasis.At this time,it is not suitable for surgical treatment.The etiology and clinical presentation of hepatocellular carcinoma is a heterogeneous disease,usually occurring in the context of chronic liver disease.It is mainly related to hepatitis b or hepatitis c and excessive alcohol consumption.In all patients,about 10% of patients with liver cancer have surgery,so non-surgical treatment is important.Non-surgical treatment mainly includes transcatheter arterial chemoembolization,local ablation,radiotherapy,chemotherapy and so on.With the development of minimally invasive technique,minimally invasive interventional therapy has become an indispensable treatment for patients with liver cancer.Minimally invasive interventional therapy is mainly for transcatheter arterial chemoembolization(TACE),radiofrequency ablation,argon-helium cryosurgery system(AHCS),microwave ablation,percutaneous ethanol injection,high intensity focused ultrasound ablation,etc.Among them,transcatheter arterial chemoembolization is a vascular interventional therapy and the other is non-vascular interventional therapy.The continuous development of minimally invasive techniques and the increase of minimally invasive methods provide a variety of treatments with high safety,precise curative effect,small side effects and few complications.Among them,argon-helium cryosurgery system is a new technology and new method that has been developed in recent years with safety and efficacy.It is a therapeutic method using hypothermia physiotherapy and local tumor target cell inactivation.It can be used alone or in combination with other methods to treat liver cancer.It can effectively kill tumor tissue and less damage liver.Therefore,we explore the clinical efficacy of TACE and TACE combined with argon-helium cryosurgery system for inoperable patients with advanced primary liver cancer,and provide clinical evidence for the selection of appropriate treatment for patients with inoperable advanced primary liver cancer.Methods:Analysis in May 2015 to June 2017 in oncology department,a total of 85 cases of inoperable in the middle-late stage primary liver cancer patients,All patients were diagnosed as primary liver cancer with CT,B-ultrasound,MRI,AFP,and pathology,diagnosis in conformity with the specification of primary liver cancer diagnosis and treatment.The inclusion criteria were:1 tumor diameter ?2cm,?10cm,number of tumors ?5;2 Liver function Child grade B above,blood routine,coagulation function,cardiopulmonary renal function normal;3 The expected survival period is more than 3 months;4 No distant transfer.The 85 patients with liver cancer were divided into two groups according to the treatment method,and the treatment group(TACE combined with argon-helium cryosurgery system)50 cases,first TACE,followed by AHCS after 3 weeks,and TACE again after 2 weeks.In the control group(TACE),35 patients were treated with TACE alone and 2-3 times as a course of treatment.The rate of tumor shrinkage in the two groups was observed,changes in AFP before and after treatment,and differences in survival rates at 6 months and 12 months.SPSS19.0 statistical software was used for statistical analysis of the data,measurement data as mean ± standard deviation((?) ± S),analysis of variance;count data using chi-square test.P<0.05 was considered statistically significant.Results:1 The tumor reduction rate of TACE combined with argon-helium cryosurgery system was better than that of TACE group,and the effective rate of treatment group was significantly higher than that in the control group,and the difference was statistically significant(P < 0.05);2 AFP was decreased after treatment in both groups,and TACE combined with argon-helium cryosurgery system group was lower than TACE group,the difference was statistically significant(P<0.05);3 There was no significant difference in survival rate between the two groups in 6 months after surgery,and the 12-month survival rate TACE combined with argon-helium cryosurgery system group was higher than that in TACE group,and the difference was statistically significant(P < 0.05);4 Both groups of patients had different degrees of liver discomfort,fever,abnormal liver function,no major bleeding,cold shock and other serious complications.The adverse reactions of TACE combined with argon-helium cryosurgery system group were more common,and there was no statistically significant difference between the two groups(P < 0.05).Conclusions:Transcatheter arterial chemoembolization combined with argon-helium cryosurgery system is a safe and reliable treatment method,which can significantly improve the survival rate of patients and is worthy of clinical application.