| Objective:To explore the short-term clinical efficacy and safety of Disodium Cantharidinate Injection combined with transcatheter arterial chemombolization(TACE)and sequential percutaneous microwave ablation(PMCT)in the treatment of advanced primary liver cancer(PLC).Methods:The clinical data of 72 PLC patients who received TACE sequential PMCT treatment from July,2016 to June,2017 in the Affiliated Hospital of Youjiang Medical University for Nationalities,were analyzed retrospectively.They were divided into the observation group(35 cases)and the control group(37 cases)according to whether the treatment was combined with Disodium Cantharidinate Injection.The control group was treated with TACE sequential PMCT therapy only.On the basis of the control group,the observation group was intravenous drip of Disodium Cantharidinate Injection 30ml every day after admission to 14 days(a course of treatment),and one course of treatment was repeated each month.The changes of Child-Pugh grade of liver function and T lymphocyte subsets in peripheral blood in two groups were observed and analyzed before treatment,in 3 months and6 months after the first PMCT treatment,respectively.The incidence of toxic side effects was also analyzed in the process of treatment.The short-term clinical efficacy of solid tumor in 3months and 6 months after the first PMCT treatment were analyzed in two groups.Results:(1)Comparison of Child-Pugh grades of liver function:there was no significant difference between the two groups before treatment(P>0.05).After 3 months and 6 months of treatment,the Child-Pugh grades of liver function were better than that before treatment,and those of the observation group were better than those of the control group,these differences were statistically significant(P<0.05).(2)Comparison of peripheral blood T lymphocyte subsets:there was no significant difference between the two groups before treatment(P>0.05).After 3 months of treatment,the CD3~+%,CD4~+%and CD4~+/CD8~+of the observation group were 66.76±8.14%,43.18±4.49%and 2.25±0.22 respectively,which were higher than those beforetreatment(56.94±9.53%,25.46±4.10%and0.87±0.03)andthecontrol group(59.85±4.37%,35.94±6.11%and 1.53±0.44).these differences were statistically significant(P<0.05).The CD8~+%of the observation group was 19.05±3.67%,which was lower than that before treatment(29.11±5.41%)and that of the control group(26.86±6.35),these differences were statistically significant(P<0.05).After 6 months of treatment,the CD3~+%,CD4~+%and CD4~+/CD8~+of the observation group were 69.52±7.33%,46.36±2.87%and 2.53±0.18 respectively,higher than those after 3 months of treatment,and those of the control group(58.34±5.83%,30.67±8.51%and 1.33±0.61),the differences were statistically significant(P<0.05).The CD8~+%of the observation group was 18.32±4.49%,which was lower than that after 3 months of treatment,and that of the control group(24.22±4.10%),these differences were statistically significant(P<0.05).(3)Comparison of the incidence of side effects in the treatment process:the incidence of myelosuppression in the observation group was 14.28%,which was lower than that of the control group(35.13%),the difference was statistically significant(P<0.05).There was no significant difference in fever,abdominal pain,abdominal distension,hiccup,pleural effusion,chest tightness and nausea and vomiting between the two groups(P>0.05).No serious complications such as ectopic embolism,subcapsular hemorrhage,needle tunnel implantation,pneumothorax,intestinal fistula,biliary fistula occurred in the two groups.(4)Comparison of recent clinical efficacy of solid tumor:3months and 6 months after treatment,the rate of complete remission(CR)and partial remission(PR)in the observation group had no significant difference compared with the control group(P>0.05).3 months after treatment,the rate of stable disease(SD)and total control(CR+PR+SD)of the observation group were 48.57%and 85.71%respectively,which were higher than those of the control group(18.91%and 64.86%),and these differences were statistically significant(P<0.05).6 months after treatment,the SD rate and total control rate in the observation group were 48.57%and 74.28%respectively,which were higher than those in the control group(13.51%and 51.35%),and these differences were statistically significant(P<0.05).3 months and 6 months after treatment,the rates of progressive disease(PD)of the observation group were 14.28%and 25.71%,respectively,lower than those in the control group(35.13%,48.64%),these differences were statistically significant(P<0.05).Conclusion:The combination of Disodium Cantharidinate Injection and TACE sequential PMCT in the treatment of advanced primary liver cancer can effectively improve the liver function of patients and anti-tumor immunity of the body,reduce the incidence of toxic side effect and enhance the control rate of the focus.Therefore,such treatment has good clinical application value. |
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