Comparison of therapeutic effects of TACE combined with microwave ablation, 125I radioactive seed implantation, Apatinib targeted therapy for large hepatocellular carcinoma / 中国医师杂志

ABSTRACT

Objective To observe the efficacy of transcatheter arterial chemoembolization (TACE) combined with microwave ablation,125I radioactive seed implantation and Apatinib targeted therapy for large hepatocellular carcinoma.Methods 120 patients with large hepatocellular carcinoma admitted to our hospital from May 2015 to May 2017 were selected as the subjects and randomly divided into four groups.30 patients in the control group were treated with TACE,30 patients in the combined treatment group 1 were treated with TACE combined with microwave ablation,30 patients in the combined treatment group 2 were treated with TACE combined with 125I radioactive seeds implantation,and 3 patients in the combined treatment group 3 were treated with TACE combined with Apatinib.The clinical efficacy,changes of alpha-fetoprotein (AFP),survival rate,levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and adverse reactions were compared among the four groups.Results The disease control rate of the combined treatment group was significantly higher than that of the control group (P ＜0.05).The reduction rate of AFP in the combined treatment group was significantly higher than that in the control group (P ＜ 0.05).There was no significant difference in survival rate between the combined treatment group 2,combined treatment group 3 and the control group at 6 months and 1 year later (P ＞ 0.05),while the survival rate of the combined treatment group 1 was significantly higher than that of the control group (P ＜0.05).After treatment,the levels of VEGF and MMP-9 in the four groups were significantly lower than those before treatment (P ＜ 0.05),and the combined treatment group was significantly lower than the control group (P ＜ 0.05).The incidence rates of adverse reactions such as elevated blood pressure,nausea and vomiting,skin itching,proteinuria and bone marrow suppression in the combined treatment group 1 were significantly lower than those in the control group (P ＜ 0.05),and the incidences of skin itching in the combined treatment group 2 and the combined treatment group 3 were significantly lower than those in the control group (P ＜ 0.05).Conclusions TACE combined with microwave ablation,125I radioactive seed implantation and Apatinib targeting therapy for large hepatocellular carcinoma are more effective than TACE alone,and TACE combined with microwave ablation can significantly prolong the survival time of patients.