Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.687
Peer-review started: January 17, 2023
First decision: March 1, 2023
Revised: March 9, 2023
Accepted: March 23, 2023
Article in press: March 23, 2023
Published online: April 27, 2023
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, which is seriously threatening the lives of patients. Due to the rapid development of the disease, patients were in the middle and advanced stages at the time of diagnosis and missed the best time for treatment. With the development of minimally invasive medicine, interventional therapy for advanced HCC has achieved promising results. Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are currently recognized as effective treatments. This study aimed to investigate the clinical value and safety of TACE alone and combined with TACE in the treatment of progression in patients with advanced HCC and to find a breakthrough for the early diagnosis and treatment of patients with advanced HCC.
To investigate the efficacy and safety of hepatic TACE and TARE in advanced descending hepatectomy.
In this study, 218 patients with advanced HCC who were treated in the Zhejiang Provincial People’s Hospital from May 2016 to May 2021 were collected. Of the patients, 119 served as the control group and received hepatic TACE, 99 served as the observation group and were treated with hepatic TACE combined with TARE. The patients in two groups were compared in terms of lesion inactivation, tumor nodule size, lipiodol deposition, serum alpha-fetoprotein (AFP) level in different periods, postoperative complications, 1-year survival rate, and clinical symptoms such as liver pain, fatigue, and abdominal distension, and adverse reactions such as nausea and vomiting.
The observation group and the control group had good efficacy in treatment efficiency, reduction of tumor nodules, reduction of postoperative AFP value, reduction of postoperative complications, and relief of clinical symptoms. In addition, compared with the control group, the treatment efficiency, reduction of tumor nodules, reduction of AFP value, reduction of postoperative complications, and relief of clinical symptoms in the observation group were better than those in the TACE group alone. Patients in the TACE + TARE group had a higher 1-year survival rate after surgery, lipiodol deposition was significantly increased and the extent of tumor necrosis was expanded. The overall incidence of adverse reactions in the TACE + TARE group was lower than that in the TACE group, and the difference had statistical significance (P < 0.05).
Compared with TACE alone, TACE combined with TARE is more effective in the treatment of patients with advanced HCC. It also improves postoperative survival rate, reduces adverse effects, and has a better safety profile.
Core Tip: The transarterial radioembolization (TARE) technique treats hepatocellular carcinoma (HCC) by perfusing radionuclide microspheres into the HCC lesion through the hepatic arterial route and releasing ionizing radiation through the radionuclide carried by the microspheres. With the development of materials science, stable radionuclide microspheres have been widely applied in clinical practice. On this basis, we found that the combined effect of transarterial chemoembolization and TARE techniques could increase the inactivation of HCC lesions, expand the scope of tumor necrosis, increase postoperative survival rate, and improve the life quality of patients. It has high clinical value in the descending treatment of patients with HCC.