Superselective transarterial ethonal embolization with ethanol-lipiodol mixture for advanced hepatocellular carcinoma

Objective To evaluate the treatment effect of transarterial ethonal embolization with ethanol-lipiodol mixture for hepatocellular carcinomas (HCC) and its side effects,compared to conventional chemoembolization.Methods A case-controlled study was undertaken with 20 patients in each group,matched on tumor characteristics,Child-Pugh grade,performance status and the times of treatment. The experimental group was treated with transarterial ethanol ablation with the ethanol-lipiodol mixture in a ratio of 1:1,and the control group was treated with chemoembolization. The side effects of the therapy were recorded after operation. The effectiveness of the two treatments were evaluated by the parameters such as tumor necrosis,tumor response,disease progression,survival rate and overall survival.Result In the TEA group,4 patients achieved complete tumor necrosis,14 patients showed the tumor necrosis area 60%. While in the matched controls,there were none complete tumor necrosis and 9 patients had tumor necrosis 60% (P=0.001). the side effects such as fever,stomachache and vomit caused by arterial embolization between the two groups were not different (P0.05). The incidence rate of bone marrow depression was higher in the control group (P0.05). The median survival in TEA group was 26 months,while it was 21 months in TACE group. The accumulative survival rate of 1 year,2 years and the response rate (CR+PR) were 90%,60% and 55% respectively in TEA group,while were 70%,35% and 30% respectively in TACE group. the total survival with the long-rank test was significantly different between the two groups. Conclusion Superselective transarterial ethonal embolization with ethanol-lipiodol mixture possesses markedly stronger anticancerous effect and lower incidence rate of bone marrow depression,and its long-term effectiveness is superior to conventional TACE.