Efficacy and safety of transcatheter arterial chemoembolization combined with cryoablation in the treatment of unresectable large hepatocellular carcinoma
10.3760/cma.j.issn.1008-6315.2018.04.011
- VernacularTitle:经导管动脉化疗栓塞术联合冷冻消融治疗不可切除性大肝癌效果与安全性分析
- Author:
Chongpei WEN
1
;
Zhidong LIN
Author Information
1. 海南医学院第二附属医院介入诊疗科
- Keywords:
Hepatocellular carcinoma;
Transcatheter arterial chemoembolization;
Cryoablation
- From:Clinical Medicine of China
2018;34(4):339-343
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the efficacy and safety of transcatheter arterial chemoembolization combined with cryoablation in the treatment of unresectable large hepatocellular carcinoma. Methods Eighty-six patients with unresectable large hepatocellular carcinoma treated in the Second Affiliated Hospital of Hainan Medical College from March 2013 to March 2015 were selected and were randomly divided into the experimental group ( 43 cases ) and the control group ( 43 cases ), and were treated with transcatheter arterial chemoembolization(TACE) combined with cryoablation therapy and TACE therapy alone. The clinical efficacy, complications related to treatment,1-year and 2-year survival rate,overall survival and progression free survival of the two groups were compared and analyzed. The COX regression analysis was used to observe the prognostic factors. Results The total effective rate in experimental group was higher than that in the control group (67. 44% (29/ 43) vs. (46. 51% (20/ 43),P = 0. 049). The 1-year survival rate,2-year survival rate and 1-year PFS rate of the experimental group were significantly higher than those in the control group (81. 40% (35/ 43) vs. 60. 47% (26/ 43),58. 14% (25/ 43) vs. 34. 88% (15/ 43),53. 49% (23/ 43) vs. 32. 56% (14/ 43),P= 0. 033,3. 031,0. 049) . There was no significant difference in the incidence of complications at grade 3 or above between the control group and experimental group ( (9. 30% (4/ 43) vs. 13. 95% (6/ 43),P = 0. 501) . COX regression analysis showed that male (OR = 1. 756,95%CI 1. 044-3. 563,P = 0. 041),hypoproteinemia (OR= 1. 523,95%CI 1. 067-2. 891,P = 0. 011) and ascites (OR = 1. 719,95%CI 1. 034-3. 108,P = 0. 031) were unfavorable to the prognosis of patients. TACE combined with cryoablation were more effective in improving the prognosis than TACE alone (OR= 0. 438,95%CI 0. 283-0. 712,P= 0. 001). Conclusion TACE combined with cryoablation is an effective and safe therapy, it also can obviously improve the survival expectancy for patients with unresectable large hepatocellular carcinoma.
