Clinical effect of low-dose dexamethasone combined with TACE for patients with primary liver cancer
Objective To observe the effect of low-dose dexamethasone as an adjunct to transcatheter arterial chemoembolization(TACE)in the treatment of patients with hepatic cell carcinoma(HCC).Methods One hundred and sixteen patients with HCC admitted to First Hospital,Nanyang Medical College from January 2021 to March 2023 were selected for the randomized controlled trial.The enrolled patients were divided into a conventional group and a combined group by the random number table method,with 58 cases in each group.There were 30 males and 28 females in the conventional group;they were(65.33±5.27)years old.There were 33 males and 25 females in the combined group;they were(65.25±5.33)years old.The conventional group took routine liver protection therapy and TACE,while the combined group low-dose dexamethasone and TACE.The levels of inflammatory factors,endothelial cell function indicators,and liver cell function indicators,incidences of postoperative complications,and medication safety were compared between the two groups.x2 and t tests were applied.Results Before the treatment,there were no statistical differences in the inflammatory factors,endothelial cell function,and liver function between the two groups(all P＞0.05).After the treatment,the levels of interleukin-1(IL-1),IL-6,and tumor necrosis factor-α(TNF-α)in the combined group were lower than those in the conventional group[(80.35±10.24)ng/L vs.(87.22±10.37)ng/L,(6.25±2.14)ng/L vs.(7.69±2.05)ng/L,and(4.25±1.47)μg/L vs.(5.33±2.06)μg/L],with statistical differences(t=3.590,3.701,and 3.250;all P＜0.05).After the treatment,the levels of 6-kelo-prototype graphic framework1α(6-kelo-PGF1α),endothelin-1(ET-1),and nitric oxide(NO)in the combined group were(175.25±20.61)ng/L,(62.11±10.47)ng/L,and(55.19±10.25)ppb,and those in the conventional group were(158.74± 20.33)ng/L,(70.25±10.33)ng/L,and(61.36±10.33)ppb,with statistical differences(t=4.343,4.215,and 3.229;all P＜0.05).The levels of alanine transaminase(ALT)and glutamic-oxaloacetic transaminase(AST)3 and 5 d after the treatment in the combined group were lower than those in the conventional group[(48.44±5.21)U/L vs.(51.28±5.44)U/L,(47.25±5.38)U/L vs.(50.66± 5.28)U/L,(36.77±5.61)U/L vs.(39.19±5.28)U/L,and(37.25±5.35)U/L vs.(40.61±5.23)U/L],with statistical differences(t=2.871,3.445,2.392,and 3.420;all P＜0.05).The incidences of TACE related complications and drug adverse reactions in the combined group were lower than those in the conventional group[6.90％(4/58)vs.18.97％(11/58)and 8.62％(5/58)vs.22.41％(13/58)],with statistical differences(x2=6.468 and 7.254;both P＜0.05).Conclusions Low-dose dexamethasone assisted TACE for patients with HCC can effectively inhibit the release of inflammatory factors and reduce vascular endothelial damage,and has a positive effect on alleviating their liver function and reducing the risk of postoperative complications.Compared with conventional liver protection drugs,low-dose dexamethasone is safer.
万方数据
维普
