The Treatment Of Massive Hepatocellular Carcinoma With TACE:the Application Experience Of Two Different Sizes Gelatin Sponge Particles

Objective.As one of the malignant tumors with high incidence,hepatocellular carcinoma ranks third in the cause of death,and the natural mortality rate in 5 years exceeds 95%.Due to the insidious onset of hepatocellular carcinoma,most patients have entered the middle and late stage of the disease.For the massive hepatocellular carcinoma that is not suitable for surgical treatment,transcatheter arterial chemoembolization(TACE)is the main treatment.To evaluate the effect that included transaminase,complications of transcatheter arterial chemoembolization(TACE)in two groups with different sizes of gelatin sponge particles(350-560um?560-750um)for the treatment of massive hepatocellular carcinoma.Methods.84 patients and 476 TACE treatments with massive hepatocellular carcinoma who underwent TACE between January 2012 and December 2017 were identified.Patients had high levels of Alpha-Fetoprotein(AFP)in the first visit(AFP?400 ng/ml).Two groups were defined by sizes of gelatin sponge particles used in TACE.For group A(350-560um),244 patients and for group B(560-750um),232 patients.transaminase levels as well as complications(pain,nausea,and vomiting),AFP levels,CT findings and development of collateral circulation before each treatment and a month after the treatment in two groups were recorded and compared.Results.(1)AFP levels,change of transaminase,and CT findings in two groups were similar(P>0.05).The incidence of pain in group A was higher than that in group B,and the differents of the two groups were statistical significance.(2)The duration of treatment in group A was longer than that in group B.In group A,the occurence of collarteral circulation after TACE was higher than group B.Conclusions.The transaminase levels,AFP levels,CT findings of sizes of gelatin sponge particles in TACE in two groups was not significantly different.Smaller sizes of GSP were leaded to pain,and the occurence of collarteral circulation will increase.Therefore,according to the patient's general condition,preoperative CT findings and intraoperative angiography,reasonable selection of embolic particles of different particle sizes is a reasonable TACE treatment for massive hepatocellular carcinoma.