[Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma].

OBJECTIVE: To evaluate the therapeutic effects and adverse effects of transarterial oily chemoembolization combined with interstitial laser thermotherapy (TOCE+ILT) in the treatment of hepatocellular carcinoma. METHODS: Totally 120 patients with hepatocellular carcinoma were randomized into two groups and received interventions with TOCE+ILT or TOCE combined with percutaneous ethanol injection (TOCE+PEI). The treatment was repeated when necessary until the tumor was completely ablated, after which the therapeutic effects were evaluated and the patients were the followed up for observing long-term clinical outcome. RESULTS: Of the 120 patients enrolled in this observation, 105 were followed up for two years (54 in TOCE+ILT group and 51 in TOCE+PEI group). The complete tumor necrosis rate of TOCE+ILT group was significantly higher than that of the TOCE+PEI group (84.8% vs 73.9%,Chi(2)=4.405, P=0.036), and TOCE+ILT was associated with a significantly higher negative conversion rate of AFP positivity (77.8% vs 56.1%, Chi(2)=4.592, P=0.032). The 1-year survival rate were similar between two groups, but the 2-year survival rate was significantly higher in patients with TOCE+ILT (79.6% vs 60.8%, Chi(2)=4.477, P=0.034). The hepatic function was comparable between the two groups before treatment, and 1 week after treatment, the ALT level in patients undergoing TOCE+ILT was significantly lower than that in patients with TOCE+PEI (95.90-/+56.06 U/L vs 116.31-/+45.27 U/L, t=2.04, P=0.043). Post-embolization syndrome was observed in the patients in two groups, but no severe adverse events were found. CONCLUSION: TOCE+ILT has good therapeutic effects and mild side effects in the treatment of hepatocellular carcinoma.

[Long-term result of combination of transcatheter arterial chemoembolization and percutaneous ethanol injection for treatment of hepatocellular carcinoma].

BACKGROUND & OBJECTIVE: Both transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) are the most important and popular procedures of interventional treatment for hepatocellular carcinoma (HCC). Although the improvement of the short-term efficacy of the combination of TACE and PEI has been proved, the long-term efficacy is seldom reported so far. The purpose of this study was to evaluate the long-term efficacy of the combination of TACE and PEI for treatment of HCC. METHODS: Six hundred and seventy-five patients with HCC from 2 cm to 15 cm in the greatest diameter (average 9.6 cm) were enrolled in this study. Among them, 179 were treated by a combination of TACE using the emulsion of lipiodol and anti-cancer drugs and PEI (TACE/PEI group) and 496 patients by TACE alone (TACE group). Ten patients in each group underwent resection after the final interventional treatment and the resected specimens were detected by histopathology method. The unresected patients had been followed up for 5-7 years and the 1-, 3-, 5 -, and 7-year survival rates were evaluated. The clinical data of the patients in two groups before intervention were comparable. RESULTS: Pathological data of two groups showed that remarkable differences were found in the mean necrosis rates (100.0+/-0.0% vs 91.5+/-7.1%, P< 0.05) and the complete necrosis rates of tumors (100% vs 20%, P = 0.0007), while there were no statistical significances in the extent of shrinkage of tumors after treatment between two groups. The results of follow-up showed that the 1-, 3-, 5-, and 7-year survival rates were 80.5%, 58.6%, 29.6%, 16.5% in TACE-PEI group, and 68.5%, 27.8%, 7.2%, 5.2% in TACE group, respectively. Significant differences were found between two groups (P< 0.01). CONCLUSION: The combination of TACE and PEI is a valuable remedy for HCC to prolong long-term survival rate.