Effect Of Transcatheter Arterial Chemoembolization Research Articles

Transarterial Chemoembolization Combined with Microwave Ablation in Elderly Patients with Recurrent Medium or Large Hepatocellular Carcinoma.

There are insufficient data about the optimal treatment for older patients with recurring medium or large hepatocellular carcinoma (HCC). The study intended to assess the effect of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) in an elderly cohort through a retrospective analysis. From 2011 to 2018, a cohort of individuals (age ≥70 years) with recurrent HCC tumors ranging from 3.1 cm to 7 cm underwent either a combination treatment of TACE and MWA (n = 43) or surgical intervention (n = 33). Using the Inverse Probability of Treatment Weighting (IPTW) technique, factors of disease-free survival (DFS), overall survival (OS), and rates of major adverse events were analyzed, retrospectively. The group that underwent surgery had a greater history of alcohol use before treatment (P= 0.001), as well as a higher Barcelona Clinic Liver Cancer (BCLC) stage for the primary tumor before treatment (P= 0.014) and a higher primary tumor location before treatment (P= 0.045). The TACE-MWA group had DFS rates of 86.2%, 68.8%, and 60.4% at 1, 3, and 5 years, while the surgery group had rates of 53.0%, 42.2%, and 25.8% at the same time points. In the TACE-MWA treatment group, survival rates at 1 year, 3 years, and 5 years post-treatment were recorded as 93.0%, 80.8%, and 65.7%, respectively, while in the surgery group, they were 62.7%, 46.9%, and 42.6%. In the univariate analysis using IPTW, the type of treatment was found to have a significant correlation with disease progression (hazard ratio [HR] 0.41, 95% CI 0.20-0.86, P=0.017). IPTW multivariate analysis showed that treatment modality (HR, 0.35; 95% CI, 0.17 to 0.79; P= 0.011) was the only significant prognostic factor for OS. In elderly patients with recurrent 3.1 cm≤ HCC ≤ 7 cm, TACE-WMA was superior to surgery in the respects of DFS and OS.

Application of radioactive iodine-125 microparticles in hepatocellular carcinoma with portal vein embolus.

Radioactive iodine-125 (125I) microparticle therapy is a new type of internal radiation therapy that has shown unique advantages in the treatment of malignant tumors, especially hepatocellular carcinoma. Patients with hepatocellular carcinoma frequently experience portal vein embolism, which exacerbates the difficulty and complexity of treatment. 125I particles, used in local radiotherapy, can directly act on tumor tissue and reduce damage to surrounding healthy tissue. Through retrospective analysis, this study discussed the efficacy and safety of radioactive 125I particles in portal vein embolization patients with hepatocellular carcinoma in order to provide more powerful evidence supporting clinical treatment. To investigate the effect of transcatheter arterial chemoembolization combined with portal vein 125I particle implantation in the treatment of primary liver cancer patients with portal vein tumor thrombus and its influence on liver function. The clinical data of 96 patients with primary liver cancer combined with portal vein tumor thrombus admitted to our hospital between January 2020 and December 2023 were retrospectively analyzed. Fifty-two patients received treatment with transcatheter arterial chemoembolization and implantation of 125I particles in the portal vein (combination group), while 44 patients received treatment with transcatheter arterial chemoembolization alone (control group). The therapeutic effects on tumor lesions, primary liver cancer, and portal vein tumor embolisms were compared between the two groups. Changes in relevant laboratory indexes before and after treatment were evaluated. The t test was used to compare the measurement data between the two groups, and the χ 2 test was used to compare the counting data between groups. The tumor lesion response rate in the combination group (59.62% vs 38.64%) and the response rate of patients with primary liver cancer complicated with portal vein tumor thrombus (80.77% vs 59.09%) were significantly greater than those in the control group (χ 2 = 4.196, 5.421; P = 0.041, 0.020). At 8 wk after surgery, the serum alpha-fetoprotein, portal vein main diameter, and platelet of the combined group were significantly lower than those of the control group, and the serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin were significantly greater than those of the control group (t = 3.891, 3.291, 2.330, 3.729, 3.582, 4.126; P < 0.05). The serum aspartate aminotransferase, alanine aminotransferase, and total bilirubin levels of the two groups were significantly greater than those of the same group 8 wk after surgery (P < 0.05), and the peripheral blood platelet, alpha-fetoprotein, and main portal vein diameter were significantly less than those of the same group before surgery (P < 0.05). In patients with primary liver cancer and a thrombus in the portal vein, transcatheter arterial chemoembolization plus portal vein 125I implantation is more effective than transcatheter arterial chemoembolization alone. However, during treatment it is crucial to pay attention to liver function injury caused by transcatheter arterial chemoembolization.

Meta-Analysis on the Therapeutic Effect of Transcatheter Arterial Chemoembolization Combined with Portal Vein Embolization.

The aim of the study was to conduct a systematic review to explore the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with portal vein embolization (PVE) for patients with hepatocellular carcinoma (HCC). Chinese and English databases (PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and VIP database) were searched from database inception to August 15, 2023. Studies comparing TACE combined with PVE versus TACE alone for patients with HCC were included. The degree of heterogeneity was assessed using I2 statistics and a Q test. The effect size was represented by risk ratio and mean difference (MD), and the effect size range was estimated using a 95% confidence interval (CI). Eight eligible studies were included in the systematic review, involving 689 participants. The results showed that the future liver residual (FLR) of patients treated with TACE combined with PVE was significantly higher than that of those treated with PVE alone (MD = 3.99%; 95% CI: 1.03-6.94). Furthermore, compared with PVE alone, TACE combined with PVE had a positive effect on disease-free survival (odds ratio [OR] = 2.16; 95% CI: 1.20-3.88), recurrence rate (OR = 0.79; 95% CI: 0.07-9.42), and complications (OR = 0.53; 95% CI: 0.30-0.96). There was no statistically significant impact on mortality with TACE combined with PVE treatment. The combination of TACE with PVE can significantly reduce the FLR of patients with HCC, with higher disease-free survival, lower recurrence rate, and fewer complications.

Retracted: Effect of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation on Liver Function and Immune Function in Patients with Hepatocellular Carcinoma.

[This retracts the article DOI: 10.1155/2022/4842370.].

Postoperative adjuvant therapy for hepatocellular carcinoma with microvascular invasion.

Hepatocellular carcinoma (HCC) is one of the most lethal tumors in the world. Liver resection (LR) and liver transplantation (LT) are widely considered as radical treatments for early HCC. However, the recurrence rates after curative treatment are still high and overall survival is unsatisfactory. Microvascular invasion (MVI) is considered to be one of the important prognostic factors affecting postoperative recurrence and long-term survival. Unfortunately, whether HCC patients with MVI should receive postoperative adjuvant therapy remains unknown. In this review, we summarize the therapeutic effects of transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine protein kinase inhibitor-based targeted therapy, and immune checkpoint inhibitors in patients with MVI after LR or LT, aiming to provide a reference for the best adjuvant treatment strategy for HCC patients with MVI after LT or LR.

Effect of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation on Liver Function and Immune Function in Patients with Hepatocellular Carcinoma.

Objectives To investigate the effects of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) on liver function and immune function in patients with hepatocellular carcinoma (HCC). Methods From December 2016 to January 2019, patients with primary liver cancer who could not be operated on were selected as the study subjects. 170 patients were randomly divided into two groups. The control group was treated with transcatheter arterial chemoembolization (n = 85). The patients in the observation group were treated with transcatheter arterial chemoembolization combined with radiofrequency ablation (n = 85). The clinical effects of the two groups were analyzed. The changes of liver function and immune function were detected by automatic biochemical analyzer before and after treatment. The changes of hypoxia inducible factor-1 (HIF1) alpha and vascular endothelial growth factor (VEGF) levels before and after treatment were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The total effective rate in the observation group was significantly higher than that in the control group (P < 0.05). After treatment, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), CD8+, HIF1 alpha, and VEGF decreased significantly (P < 0.05), while levels of total bilirubin, direct bilirubin, indirect bilirubin, CD3+, CD4+, and CD4+/CD8+ increased significantly (P < 0.05). The changes of the above indexes in the observation group were more significant than those in the control group (P < 0.05). Conclusion Hepatic arterial chemoembolization combined with radiofrequency ablation has a significant effect on liver function and immune function in patients with liver cancer, which may be related to the abnormal levels of HIF1α and vascular endothelial growth factor.

Transcatheter arterial chemoembolizationplus atezolizumab and bevacizumab for unresectable hepatocellular carcinoma: a single-arm, phase II trial.

The therapeutic effect of transcatheter arterial chemoembolization (TACE) is limited for patients with hepatocellular carcinoma (HCC). Herein, we designed an open-label, single-arm phase II clinical trial to investigate the efficacy and safety of TACE combined with atezolizumab plus bevacizumab for patients with Barcelona Clinic Liver Cancer (BCLC) stage-B HCC. Patients will initially receive TACE. Atezolizumab and bevacizumab will be initiated 2-14days after the first TACE session. TACE will be repeated on demand. The primary endpoint is the objective response rate. The secondary end points include overall survival, disease control rate, progression-free survival, time-to-progressionand safety. The study results will provide evidence for establishing a novel therapeutic regimen for patients with unresectable HCC. Clinical Trial Registration: ChiCTR2100049829 (ChiCTR.org).

Transcatheter Arterial Chemoembolization in Combination With High-Intensity Focused Ultrasound for Intermediate and Advanced Hepatocellular Carcinoma: A Meta-Analysis.

BackgroundThe study was conducted to explore whether high-intensity focused ultrasound (HIFU) can improve the effect of transcatheter arterial chemoembolization (TACE) in intermediate and advanced hepatocellular carcinoma (HCC).MethodsPubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, CQVIP, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical (CBM) databases were searched for randomized controlled trials (RCTs) comparing the effect of TACE in combination with HIFU group (group A) to TACE alone group (group B) in treating intermediate and advanced HCC. The primary outcomes were overall survival (OS) rate and tumor response rate. The odds ratio (OR) and 95% confidence interval (CI) for each study were calculated and then pooled with fixed effects model or random effects model. Sensitivity analyses and subgroup analyses were conducted. A publication bias was also evaluated.ResultsAfter literature selection, eleven RCTs involving 803 patients were included in this meta-analysis. This meta-analysis revealed that group A was associated with an increased 6-month OS rate (OR = 0.20), 12-month OS rate (OR = 0.23), 24-month OS rate (OR = 0.32), and overall response rate (WHO criterion, OR = 0.22; RECIST criterion, OR = 0.30). Furthermore, subgroup analyses showed no bias in the result. Given the limited number of studies that reported major complications, no additional meta-analysis of complication was conducted. Despite no special treatment, any complication following HIFU treatment was found to subside within 3-7 days.ConclusionTACE in combination with HIFU is associated with increased OS and tumor response in intermediate and advanced HCC. Current evidence supports the use of HIFU after TACE treatment in intermediate and advanced HCC.

The Effectiveness of Transcatheter Arterial Chemoembolization in the Treatment of Unresectable Hepatic Metastases

The Effectiveness of Transcatheter Arterial Chemoembolization in the Treatment of Unresectable Hepatic Metastases

IL-17 predicts the effect of TACE combined with apatinib in hepatocellular carcinoma.

IL-17 is considered to be a cancer-promoting gene in hepatocellular carcinoma (HCC). Here, we explored the effect of IL-17 in predicting the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with apartinib in patients with HCC in this study. Established of IL-17 knockdown SK-Hep1 cells for studying the effects of IL-17 expression on the invasion and migration of human HCC cells in vitro by transwell assay and tumor angiogenesis in nude mouse. Immunohistochemistry was used to detect the expression of IL-17, E-cadherin, Vimentin and CD34 protein in 175 cases of human HCC tumor tissues. Kaplan-Meier was used to analyze the prognostic significance of TACE combined with apatinib treatment in HCC patients. n SK-Hep1 cells, IL-17 knockdown could increase E-cadherin protein expression, reduce vimentin protein expression, inhibit cell invasion and migration in vitro, and inhibit angiogenesis of tumor and decrease plasma VEGF level in nude mouse. In tumor tissues of HCC patients, IL-17 protein expression was negatively correlated with E-cadherin protein expression (r = -0.622, P < 0.001), positively correlated with Vimentin protein expression (r = 0.540, P < 0.001), and was positively correlated with MVD of HCC tumor tissues (r = 0.564, P < 0.001). Compared with adjuvant TACE alone, patients with low-expression of IL-17 treated combined with apatinib have a higher 5-year overall survival. However, additional apatinib treatment did not significantly improve 5-year overall survival in HCC patients with high IL-17 expression. IL-17 had a pivotal role in the invasion and angiogenesis of HCC and contribute to the selection of patients who may benefit from adjuvant TACE combined with apatinib.

Serum TSGF and miR-214 levels in patients with hepatocellular carcinoma and their predictive value for the curative effect of transcatheter arterial chemoembolization.

The purpose of this study is to evaluate the expression of tumor-specific growth factor (TSGF) and microRNA-214 (miR-214) in the serum of patients with primary hepatocellular carcinoma (PHC) and their predictive values for the curative effect of transcatheter arterial chemoembolization (TACE). A retrospective analysis of the clinical data of 87 PHC patients were treated with TACE. According to the curative effect 1 month after TACE, PHC patients were divided into disease control group (n=56) and disease progression group (n=31). The expression levels of TSGF and miR-214 were detected by qRT-PCR before or after treatment with TACE in disease control group and disease progression group. The predictive value of TSGF and miR-214 for the efficacy of TACE were evaluated by the receiver operating characteristic (ROC) curve. The Kaplan-Meier survival curve was drawn according to the critical value of ROC. The effect of pretreatment levels of TSGF and miR-214 was analyzed on the three-year survival rate of patients. After TACE treatment, the mRNA expressive of serum TSGF were increased in progression group, while the levels of miR-214 were decreased compared with control group (P<0.05). Importantly, at one month after TACE treatment, the levels of TSGF were decreased in control group and progression group, while the expression of miR-214 was increased compared with in both groups before TACE treatment(P<0.05). The result of ROC analysis showed that for predicting the curative effect of TACE, the levels of TSGF and miR-214 expression were (181.32, 0.63) (0.849 and 0.807) and (0.759-0.938, 0.707-0.907) in the cutoff values, AUCs and 95% confidence intervals, respectively. The result of Kaplan-Meier analysis showed that the 3-year survival rate of the low TSGF group was up-regulated than that of the high TSGF group [65.12% (31/44) vs. 30.23% (13/43); χ2=5.014; P=0.025]. The 3-year survival rate of the miR-214 high expression group was up-regulated than that of the miR-214 low expression group [61.70% (29/47) vs. 30.00% (12/40); χ2=6.928; P=0.008]. Serum TSGF and miR-214 could be used as potential biomarkers for PHC diagnosis and prognosis.

Enhanced therapeutic effect of transcatheter arterial chemoembolization combined with radioactive I-125 seed implantation on liver cancer.

The present study aimed to evaluate the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with radioactive I-125 (iodine-125) seed implantation on liver cancer. A total of 38 liver cancer patients in the combined treatment group were treated with lobaplatin-TACE combined with radioactive I-125 seed implantation, while 45 patients in the TACE group were treated only with lobaplatin-TACE. Patients were followed up for survival time, and the liver function, change in α-fetoprotein (AFP) and side effects were evaluated. The average survival time of patients was 6.1 months in the TACE group and 8.2 months in the combined treatment group, and the overall survival was significantly different between the two groups (P<0.05). The response rate of lesions in the combined treatment group was superior to that observed in the TACE group, and the change in AFP in the TACE group was smaller than that in the combined treatment group. Improvement in the effects on most liver function indices in the combined treatment group were better than those in the TACE group. In addition, there were no differences in the side effects experienced between the two groups. Results of this study indicate that the effect of TACE combined with radioactive I-125 seed implantation is superior to that of TACE alone for the treatment of liver cancer, which can further benefit patients.

Transcatheter arterial chemoembolization alone or combined with ablation for recurrent intermediate-stage hepatocellular carcinoma: a propensity score matching study.

The recurrence after curative hepatectomy is common. Limited data have investigated the effect of transcatheter arterial chemoembolization (TACE) combined with ablation in treating recurrent intermediate-stage hepatocellular carcinoma (HCC) after hepatectomy. We aim to compare the efficacy of TACE combined with ablation versus TACE alone in treating recurrent intermediate-stage HCC after hepatectomy. A total of 183 patients with recurrent intermediate-stage HCC after hepatectomy were enrolled at Sun Yat-sen University Cancer Centre, including 111 patients who underwent TACE alone and 72 patients who underwent TACE combined with ablation (TACE-Ablation). Overall survival (OS) and progression-free survival (PFS) were compared by the log-rank test. Propensity score matching (PSM) was used to reduce the confounding bias. Before PSM, the 5-year OS rates were 43.3% vs. 27.9% (P = 0.001), and the 5-year PFS rates were 21.7% vs. 13.0% (P < 0.001) for TACE-Ablation and TACE-alone groups, respectively. After PSM, TACE-Ablation still resulted in better 5-year OS (41.6% vs. 30.2%, P = 0.028) and 5-year PFS rate (21.3% vs. 15.8%, P = 0.024) than that of TACE alone. Patients in TACE-Ablation group exhibited similar major complication rates to TACE-alone group but higher minor complication rates both before and after PSM. Cox regression analysis identified TACE-alone modality as an independently unfavourable predictor for OS and PFS (both P < 0.05). TACE combined with ablation is safe and superior to TACE alone in tumour control and prolonging overall survival in recurrent intermediate-stage HCC after hepatectomy.

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

PurposeTo evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC).Materials and methodsFrom June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS).ResultsThe technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test).ConclusionStereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.

Efficacy of transcatheter arterial chemoembolization combined with sorafenib in inhibiting tumor angiogenesis in a rabbit VX2 liver cancer model

BackgroundThe aim of this study was to investigate the effects of transcatheter arterial chemoembolization (TACE) combined with sorafenib on tumor angiogenesis. Materials and methodsThirty New Zealand rabbit VX2 liver cancer model animals were divided into five groups, which received either normal saline (A), TACE (B), sorafenib (C), sorafenib followed by TACE (D), or TACE followed by sorafenib (E). Serum vascular endothelial growth factor (VEGF) levels were measured before and after TACE via ELISA. Immunohistochemistry for CD34 was performed to evaluate microvessel density (MVD), and ultrasonography was used to access tumor volume. ResultsVEGF levels declined in group C but increased significantly on the 3rd post-operative day in groups B, D, and E. Levels decreased after the 7th post-operative day. Peak levels were significantly lower in group D than in groups B and E. On the 14th post-operative day, VEGF levels were the lowest in group C, followed by those in groups D and B. MVD was the lowest in group C followed by that in group D and E, and was the highest in group B. Group D had the smallest tumor volume. HE staining of tumor tissues from group C showed apoptosis in a scattered patchy pattern, whereas in groups B, D, and E, large areas of tumor cell necrosis were visible. ConclusionTACE can up-regulate serum VEGF levels, which in turn accelerates the formation of new blood vessels. Thus, TACE combined with sorafenib inhibits VEGF and angiogenesis, and pre-operative administration of sorafenib has a more superior anti-angiogenic effect than post-operative administration.

Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus

Objective To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared. Results There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P 0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05). Conclusion For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival. Key words: Carcinoma, hepatocellular; Portal vein tumor thrombus; Transcatheter arterial chemoembolization; Iodine radioisotopes

Curative effect of TACE combined with Antike in the treatment of primary liver cancer

Objective To evaluate the curative effect of transcatheter arterial chemoembolization (TACE) combined with Antike in the treatment of primary liver cancer. Methods The data of 72 patients with primary liver cancer (90 lesions in total) admitted to the First Affiliated Hospital of Hebei North University from August 2016 to December 2017 were retrospectively analyzed. All patients were divided into the observation group (n=36) and the control group (n=36) according to the therapeutic schedule. The patients in the control group (40 foci) were treated with TACE only, and the patients in the observation group (50 foci) received TCAE treatment, oral Antike capsules were taken at the same time with the frequency of three times a day, two capsules each time, and six weeks were planned for one treatment cycle. A total of four cycles were completed. All patients underwent CT enhancement scans one week before TACE treatment and six months after treatment. According to Response Evaluation Criteria in Solid Tumors, complete remission and partial remission were deemed as effectivity.The imaging data of the change of tumor size, postoperative tumor residual, tumor capsule growth and new intrahepatic metastases were analyzed and used to evaluate the curative effect of patients in the two groups. Results After 6 months of treatment, there were 39 effective lesions in the observation group and 23 in the control group. The total effective rate of the observation group was higher than that of the control group (78.0% vs. 57.5%), and the difference was statistically significant (χ2=4.357, P=0.037). Twenty-three neoplastic capsule lesions were detected in the observation group and 9 in the control group. The detection rate of neoplastic capsule was higher in the observation group than that in the control group (46.0% vs. 22.5%), and the difference was statistically significant (χ2=5.356, P=0.021). There were 27 residual tumors and 5 new intrahepatic metastases in the observation group, 30 residual tumors and 13 new intrahepatic metastases in the control group. The residual tumor rate and neohepatic metastasis rate in the observation group were lower than those in the control group (54.0% vs. 75.0%; 13.9% vs. 36.1%), and the differences were statistically significant (χ2=4.220, P=0.040; χ2=4.741, P=0.029). Conclusion TACE combined with Antike is safe and effective in the treatment of primary liver cancer. It can improve the total clinical efficiency, promote the growth of tumor capsule, and reduce the recurrence rate and metastasis rate of tumor. It is worthy of clinical application. Key words: Tomography, spiral computed; Liver neoplasms; Transcatheter arterial chemoembolization; Antike

Effects of TACE combined with precise RT on p53 gene expression and prognosis of HCC patients.

To investigate the effects of transcatheter arterial chemoembolization (TACE) combined with precise radiation therapy (RT) on p53 gene expression and prognosis of patients with hepatocellular carcinoma (HCC). A total of 80 patients with unresectable HCC treated in the First People's Hospital of Qinhuangdao from March 2009 to March 2015 were randomly divided into TACE group (n=40) and TACE + RT group (n=40). Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of p53 in both groups before and after treatment. The biochemical indexes of liver function [α-fetoprotein (AFP), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT)] were detected. Moreover, adverse reactions were compared between the two groups of patients, the short-term therapeutic effect was evaluated, and effects of two treatment methods on progression-free survival (PFS) and overall survival (OS) of patients were detected. There were no statistically significant differences in clinical data between the two groups of patients (P>0.05). The p53 protein levels were significantly downregulated in both treatment methods, and it was decreased more significantly in TACE + RT group than that in TACE group (P<0.05). Compared with those before treatment, AFP and GGT levels in both groups of patients after treatment were decreased, but the levels of ALT were increased (P<0.05), and TACE + RT group had a better curative effect than TACE group (P<0.05). Besides, the incidence rate of adverse reactions in TACE + RT group (37.5%) was obviously lower than that in TACE group (65%) (P<0.05). The number of patients with stable disease (SD) and progressive disease (PD) and disease control rate (DCR) in TACE + RT group were superior to those in TACE group (P<0.05). The 2-year survival rate and median PFS of patients in TACE + RT group were also significantly better than those in TACE group (P<0.05). In conclusion, TACE combined with RT has a better clinical effect than TACE alone in the treatment of HCC.

Comparison of therapeutics effects of transcatheter arterial chemoembolization combined with iodine-125 seed implantation and sorafenib for the treatment of hepatocellular carcinoma with portal vein tumor thrombosis

Objective: To explore the factors affecting the prognosis of patients with hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT), and to analyze the clinical value of transcatheter arterial chemoembolization (TACE) combined with iodine-125 seed implantation in such patients. Methods: A retrospective analysis of 53 patients with HCC combined with PVTT was performed. In the study group, 32 cases were treated with TACE combined with iodine-125 seed implantation, and 21 cases in the control group were treated with TACE combined with sorafenib. Survival analysis was carried out on eight factors such as gender, age, Child-Pugh classification, alpha fetoprotein level, portal vein tumor thrombosis (PVTT) type, forms of liver tumor, extra-hepatic metastasis and treatment modalities. The efficacy of TACE combined with iodine-125 seed implantation and TACE combined with sorafenib was further compared. The χ (2) test was used to evaluate the efficacy of the two groups. A single factor survival analysis was calculated by Kaplan-Meier estimator and multifactor survival analysis by Cox proportional hazards model. Results: All 53 patients were successfully treated. The median tumor progression time (mTTP) and median overall survival (mOS) were 8 months and 11 months, respectively. The disease control rate (DCR) of the study group for PVTT was 93.8%, which was significantly higher than that of the control group (61.9%, χ (2) = 6.448, P = 0.011). The difference was statistically significant; the objective remission rate of the study group for PVTT was 75.0%. Significantly higher than 9.5% in the control group, P < 0.05, the difference was statistically significant; the DCR of the primary tumor in the study group was 50.0%, which was lower than the 70.0% of the PVTT in the control group, P = 0.231, the difference was not statistically significant. The progression of primary HCC lesions in patients with multivariate survival analysis: Child-Pugh grade A patients were compared to grade B [Hazard ratio (HR) = 0.236, P = 0.003]; no extra-hepatic metastasis (HR = 0.258, P = 0.002); and TACE combined with iodine-125 seed implantation group compared with TACE combined sorafenib group (HR = 0.372, P = 0.002), the differences were statistically significant. Multivariate survival analysis of patients with overall survival: AFP < 400 ng/mL vs. AFP≥400 ng/mL (HR = 0.389, P = 0.030); Child-Pugh grade A vs. B (HR = 0.263, P = 0.006); and no extra-hepatic metastasis (HR = 0.306, P = 0.006), the differences were statistically significant. Conclusion: TACE combined with iodine-125 seed implantation for the treatment of HCC with PVTT can effectively control the progression of PVTT and intrahepatic lesions and improve the prognosis of patients.

Effect of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of liver cancer

Objective To investigate the effect of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in the treatment of liver cancer, and its influence on the serum markers. Methods 108 patients with primary liver cancer were selected as the subjects of this study.According to the random number table method, the patients were divided into two groups.The control group (54 cases) received TACE treatment, and the observation group (54 cases) received TACE combined with RFA treatment.The treatment effects, the changes of tumor recurrence related indicators and the levels of tumor related indicators were compared and analyzed. Results The effective rate of the observation group was 79.7%(43/54), which was significantly higher than 50.0%(27/54) of the control group (χ2=10.391, P=0.001). After treatment, the E-calcium protein (EC), vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP), tumor recurrence index alpha fetoprotein (AFP), CA199, glutamate transferase (GGT) levels in the observation group were (1 738.8±114.8)μg/L, (207.9±37.2)ng/L, (34.9±4.6)ng/L, (72.2±19.5)μg/L, (34.2±5.1)U/L, (88.9±9.4)U/L, respectively, which were significantly lower than those in the control group[(2 382.4±159.4)μg/L, (367.3±49.3)ng/L, (72.1±7.4)ng/L, (135.2±21.8)μg/L, (66.9±8.2)U/L, (124.6±12.5)U/L], the differences were statistically significant(t=24.076, 18.967, 31.373, 15.828, 24.884, 16.774, all P<0.05). Conclusion TACE combined with RFA is effective in the treatment of liver cancer, which can effectively kill tumor cells and reduce the contents of serum tumor markers, and it is worthy of popularizing in clinic. Key words: Liver neoplasms; Embolization, therapeutic; Radiofrequency ablation; Tumor marker