Prospective Clinical Study of Advanced Hepstocellular Carcinoma treated by Transcatheter Arterial Chemoembolization with Embosphere Microspheres

Purpose To explore clinic efficacy of multiple transcatheter arterial chemoembolization in the treatment of advanced hepatocellular carcinoma.Methods According to the EASL diagnostic standard,100 patients with unresectable advanced hepatocellular carcinoma were to be make a final diagnosis from December 2011 to March 2012.They are all initial treatment,According to the exclusion criteria,excluding 54 cases,the remaining 46 patients were assigned into two groups:the microspheres group( microspheres plus chemotherapy group) and lipiodol group( lipiodol plus chemotherapy group),depending on the use of embolic agents.24cases in the microsphere group,aged( 51.75 ± 8.19)( 38 ~ 67years old),and 22 patients( 55.0 ± 6.36)( 42 ~ 68 years old) in the lipiodol group.Within 6 months,all patients underwent 3 to 4 times microspheres or lipiodol arterial chemoembolization.Observed the accumulated adverse reactions and occurrence of complications of the two groups after repeatedly therapy,Comparing two groups of patients with liver function and AFP levels before therapy and a month after the last intervention,Under the mRECIST standard comparing two groups of efficiency and benefit rate.Results There were none serious complications in the both two groups.After repeatedly therapy,comparing control group,the liver function of the microsphere group had no significant difference,Enhanced CT or MRI of last embolization treatment a month follow-up shows,the microsphere group CR,PR,SD and PD patients count respectively for the 2cases( 8.3%),12 patients( 50%),6 cases( 25%) and 2 cases( 8.3%),the overall response rate( CR + PR) was 58.3%,the clinical benefit rate( CR + PR + SD) was 91.7%,and the lipiodol group was 0 cases,5 cases( 22.7%),11 cases( 50%) and 6 cases( 27.2%),the response rate( CR + PR) was 22.7%,the benefit rate( CR + PR + SD) was 72.7%,After multiple chemoembolization,under the tumor change evaluation standard of mRECIT,the difference of the two groups was statistically significant( χ2=8.353,P = 0.039),moreover,the AFP change was in a statistically significant difference( χ2= 3.997,P = 0.046) after treatment.Conclusion TACE treatment with use of embosphere microspheres as embolic agents for embolizing advanced hepatocellular carcinoma had more effective response than that by lipiodol.It is safe for patients with advanced hepatocellular carcinoma to receive repeatedly TACE with embosphere microspheres.