Observation Of Curative Effect Of Radiofrequency Ablation And ¹²⁵I Radioactive Particles On Advanced Unresectable Liver Cancer

Objective:To observe the clinical efficacy of ¹²⁵I radioactive particles and radiofrequency ablation for the treatment of advanced unresectable liver cancer,so as to provide a reference for the clinical treatment of advanced unresectable liver cancer.Methods:A systematic review was made upon the clinical data of patients with advanced unresectable liver cancer who underwent radiofrequency ablation and who treated with ¹²⁵I radioactive particle therapy during the period from September 2016 to November 2018 in my hospital,and qualified cases were selected in strict accordance with the inclusion and exclusion criteria,including:（1）Basic information of the cases,such as: patient’s age,patient’s sex,location of the primary tumor,presence or absence of liver metastasis,etc;（2）Surgery information: operation date,number of particles used,and number of cold cycle radiofrequency ablation needles used;（3）The occurrence of postoperative adverse reactions;（4）Laboratory examinations: check the patient’s liver function and tumor markers before surgery and 1 month after surgery,and every 3 months after surgery;（5）Imaging data: Patients were diagnosed with abdominal ultrasound and abdominal enhanced CT scans before and 1 month after surgery and every 3 months after surgery;（6）Local recurrence: abdominal enhanced CT,abdominal ultrasound and comprehensive evaluation of local tumor recurrence with tumor markers all followed up every 3 months;（7）Survival status: Follow-up is performed every 3 months after surgery.The follow-up mainly focuses on understanding the patient’s survival status and analyzing the cause of death,combined with the results of abdominal enhanced CT before and after surgery,and evaluate the 3-month local control rate with reference to the improved version of solid tumor evaluation standard m RECIST.Observe the local recurrence rates of two groups in one year after surgery.as well as the survival condition of two groups in one year after surgery.Use Logistic regression analysis to analyze the influencing factors of local control rate and survival rate,and determine the main influencing factors based on the analysis results.Results:1.Local control rate and influencing factors: The 3-month local control rates of patients with radiofrequency ablation and patients with ¹²⁵I radioactive particles after surgery was 76%（38/50）、80%（40/50）,respectively.There was no statistical difference between the groups（P>0.05）.Through Logistic regression analysis on the possible influencing factors of local control rate,the most important factor is the tumor diameter.2.The 1-year local recurrence rates after surgery were 54%（27/50）in the radiofrequency ablation group and 30%（15/50）in the particle therapy group.There was a statistical difference in the one-year local recurrence rates after surgery between the two groups of patients（P<0.05）.3.Adverse reactions: 38 patients treated with radiofrequency ablation had adverse reactions,the incidence of adverse reactions was 76%,among them 8 patients had nausea,22 patients had pain in the operation area,8 patients had postoperative fever.The incidence of adverse reactions in patients treated with ¹²⁵I radioactive particles was 40%,adverse reactions occurred in 20 cases,including 4 cases of nausea,13 cases of pain in the operation area,and 3 cases of postoperative fever.The adverse reactions of the two groups of patients were significantly improved after active symptomatic treatment.Through statistical analysis.The incidence of adverse reactions was different between the two groups（P<0.05）.4.One-year survival after the operation: There were 9 deaths in 50 patients treated with radiofrequency ablation,including 3 liver metastases and 6 liver tumors;there were 8 deaths in 50 patients treated with ¹²⁵I radioactive particles,including 5 liver metastases and 3 liver tumors.All died of tumor metastasis or tumor complications and were not caused by surgery.There was no statistical difference in the 1-year survival rates of patients treated with the two surgical methods（P>0.05）.5.Analysis of influential factors of postoperative survival: Logistic regression analysis was used to explore the possible influential factors of postoperative survival time of patients,and it was concluded that there was no statistical significance in the influence of age,gender,number of lesions and tumor diameter on postoperative survival time（P > 0.05）.Conclusion:1.Radiofrequency ablation and ¹²⁵I radioactive particles implantation have significant localized effects in the palliative treatment of advanced unresectable liver cancer,and tumor diameter is a key factor affecting the localized effect of the two.2.In the palliative treatment of advanced unresectable liver cancer,¹²⁵I radioactive particles is a safe and effective treatment which has the advantages of low postoperative local recurrence rate and small postoperative adverse reactions.3.For patients with advanced unresectable liver cancer,whether treated with radiofrequency ablation or ¹²⁵I radioactive particle therapy,both are local treatment methods,which can not prevent the new metastases.It is recommended that they be combined with other treatments in clinical application.