| Objective:To evaluate the short-term clinical efficacy and safety of transarterial chemoembolization using Calli Spheres~?drug-eluting beads plus lipiodol and compared with conventional TACE in treating large liver cancer.Methods:The clinical data of a total of 55 patients with large liver cancer during the period from January 2017 to June 2019 were retrospectively analyzed.These patients were grouped by the different embolic material used in TACE.Among them,26 patients were assigned to the experimental group who were treated with TACE using Calli Spheres~?drug-eluting beads plus lipiodol,and 29 patients were assigned to the control group who were treated with conventional TACE(C-TACE,using lipiodol plus Gelfoam or microspheres).The results of the enhanced CT/MRI of middle and upper abdomen were recorded and evaluated with m RECIST at one and 3 months after TACE.The alpha-fetoprotein(AFP)levels at one month of the two groups were compared with the preoperative datas.The progression free survival(PFS)was recorded and compared between the two groups.Besides,the liver function indexes of the two groups were recorded at one week and one month after TACE and compared with the preoperative datas.The postoperative adverse reactions and complications of the two groups were analyzed.Results:1.There were no significant differences in gender,age,cirrhosis,liver function(Child-Pugh classification),BCLC staging,ECOG score,tumor diameter and number,and portal vein tumor thrombus between the two groups(P>0.05).2.At one month after TACE,the objective response rates(ORR)of the experimental group and the control group were 92.3%and 82.8%respectively,while the disease control rates(DCR)were 96.2%and 93.1%respectively.The ORR and DCR were increased in the experimental group compared with the control group at one month after TACE,but there were no statistically significant differences between the two groups(P>0.05).At 3months after TACE,the ORR of the experimental group and the control group were 88.5%and 65.5%respectively,while the DCR were 92.3%and 86.2%respectively.The ORR was increased in the experimental group compared with the control group at 3 months after TACE(P<0.05),but no difference in DCR was observed between the two groups(P>0.05).3.At one month,the AFP level of the two groups both decreased to a different extent compared with the preoperative one,but a significant decrease in AFP level of the experimental group was observed(P<0.05),while the decrease in AFP level of the control group was no statistically significant(P>0.05).4.The median PFS of the experimental group and the control group were 9 months and 8 months respectively,and no difference in PFS was observed between the two groups(P>0.05).5.One week after TACE,the levels of ALT and TBIL of the two groups were obviously increased,while the levels of ALB were somewhat decreased compared with the preoperative datas.One month after TACE,the liver function indexes basically restored to the preoperative baseline levels,and no statistically significant differences existed between the two groups(P>0.05).6.The postoperative adverse reactions of the two groups of patients mainly included abdominal pain,fever,nausea and vomiting,which were relieved within 3-5 days after symptomatic treatment.There were no serious complications in each group such as acute liver,renal failure,liver abscess,bile tumor,gastrointestinal bleeding,and bone marrow suppression,and there were no statistically significant differences in adverse reactions between the two groups(P>0.05).Conclusion:1.The use of Calli Spheres~?drug-eluting beads combined with lipiodol is safe and feasible with satisfactory short-term efficacy in treating large liver cancer.2.For the treatment of large liver cancer with TACE,the use of Calli Spheres~?drug-eluting beads combined with lipiodol has a better tumor objective response at 3 months after operation compared with C-TACE.The PFS and safety of the two groups are similar. |
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