Patients with advanced primary hepatocellular carcinoma treated by melatonin and transcatheter arterial chemoembolization: a prospective study.

OBJECTIVE: To observe the clinical efficacy of transcatheter arterial chemoembolization (TACE) and TACE+MLT (melatonin) on inoperable advanced primary hepatocellular carcinoma. METHODS: From January 1997 to January 1998, one hundred patients with inoperable advanced primary hepatocellular carcinoma were treated separately by TACE (50) and TACE+MLT (20 mg/d at 8:00 PM orally, 7 days before TACE)(50). RESULTS: The effective rates (WHO standards) of TACE and TACE+MLT were 16% and 28% respectively (P<0.05). After TACE or TACE+MLT, the resection rate at two-stage of TACE was 4% or 14% (P<0.01). The 0.5-, 1- and 2-year survival rates in the TACE group were 82%, 54% and 26% respectively; in the TACE+MLT group 100%, 68% and 40% respectively. The results were significantly better in the TACE+MLT group than in the TACE group. MLT could protect liver function from the damage caused by TACE. The IL-2 levels of all patients significantly increased, whereas sIL-2R expressions decreased after TACE+MLT as compared with the TACE group (P<0.01). CONCLUSIONS: With definite protection and treatment effect on the liver function damage caused by TACE, MLT can enhance the immunological activities of patients. It also can improve the effect of TACE by increasing the survival and resection rate after two-stage operation.