Lamivudine combined with transcatheter arterial chemoembolization in treatment of HBV-related hepatocellular carcinoma

OBJECTIVE: To evaluate the therapeutic effects of combination lamivudine and transarterial chemoembolization(TACE) in HBV-related hepatocellular carcinoma(HBVR-HCC).METHODS: Totally 89 HBVR-HCC patients without indications for surgery from February 2007 to February 2011 were divided into two groups.Forty-eight patients in combination group received lamivudine and TACE and 41 patients in control group underwent TACE only.Alanine(ALT),Child-Pugh score HBV DNA load,AFP level and negative conversion rate of HBeAg were checked in pre-treatment and post-treatment 4,12,24,48 weeks and therapeutic effects,adverse reactions and survival of two groups were retrospectively analyzed.RESULTS: With treatment prolong,the ALT levels,Child-Pugh score and AFP level of two group patients were gradually improved and the AFP levels and Child-Pugh score gradually decreased,that in combination group were(49.36±11.79) U/L,(7.14±0.83),(85.74±41.72) μg/mL,(3.28±0.56) Lg at 24 weeks and(41.84±10.73) U/L,(6.81±0.78),(46.59±14.66) μg/mL,(2.85±0.72) Lg at treatment 48 weeks,respectively;in control group were(68.66±18.57) U/L,(7.56±1.07),(116.54±72.35) μg/mL,(6.73±1.15) Lg at treatment 24 weeks and(66.48±19.33) U/L,(7.41±0.91),(82.25±38.87) μg/mL,(6.67±1.49) Lg at treatment 48 weeks,respectively.The difference between two groups showed statistically significant(P24Wvalue was 0.010,0.037,0.006 and 0.017,P48W value was 0.007,0.022,0.003 and 0.002).Negative conversion and transfer rate of HBeAg in combination group were 27.08% and 6.25%,and that in control group were 0,difference between them was significant(P=0.001).Total efficiency rate of combination group(79.7%) showed significantly in statistics difference compared to control group(65.86%,χ2=4.42,P=0.031).The 1-year survival rates in combination group and control group were 81.25% and 78.05%,the difference between them was not significant(χ2=1.92,P=0.142),while the 2-years survival rates were 31.25% and 19.51%,the difference showed obvious statistic significance(χ2=6.18,P=0.017).The rate of complications and adverse effects were 20.83% and 21.95% in combination group and control group,the rate between them had no noticeable difference(χ2=0.522,P=0.393).CONCLUSION: Treatment HBVR-HCC by using combination lamivudine and TACE can significantly improve liver function and the control of HBV,promote clinical efficacy without increasing side effects.