A comparison between TACE combined with sorafenib or 125I seed implantation for the treatment of hepatocellular carcinoma patients with portal vein tumor thrombus and arteriovenous fistula
Objective To compare the efficacy of TACE combined with sorafenib and TACE combined with 125I seed implantation for the treatment of hepatocellular carcinoma(HCC)patients with portal vein tumor thrombus and arteriovenous fistula.Methods Sixty-two patients with HCC,portal vein thrombosis,and arteriovenous fistula admitted in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine between April 2019 and April 2022 were enrolled in this study.The patients in the control group were treated with TACE combined with sorafenib,and the patients in the observation group was treated with TACE combined with 125I seed implantation.Results The total effective rate in the observation group(83.8％)was higher than that in the control group[(58.0％),P＜0.05];the serum levels of alpha fetoprotein(AFP),PLT,WBC,and RBC in the observation group were(213.3±8.6)ng/mL,(154.3±8.3)× 109/L,(4.2±0.5)× 109/L,(2.0±0.3)× 1012/L,respectively.Both groups were superior to the control group[(117.5±6.8)ng/mL(168.7±10.9),respectively × 109/L,(5.7±0.7)× 109/L,(3.8±0.8)× 1012/L,P＜0.05];the levels of AST,ALT,TBil and Alb in the observation group were(23.5±7.8)IU/L,(30.68±4.9)IU/L,(6.7±2.7)μmol/L,and(39.8±2.8)g/L,respectively,all were better than those of(35.6±12.6)IU/L,(34.3±6.3)IU/L,(13.2±2.5)μmol/L,and(36.0±2.3)g/L in the control group(P＜0.05).The incidence of complications such as fever,ascites,nausea,vomiting,and infection in the observation group was significantly lower than those in the control group(P＜0.05).Conclusion Compared with TACE combined with sorafenib,TACE combined with implantation of 125I particles for treating HCC patients with portal vein thrombosis and arteriovenous fistula has less impact on liver function,with a better improvement in the treatment effect,relief of symptoms and reduction of complications,which is worthy of clinical use.
Hepatic artery chemoembolizationSorafenib125I particlesHepatocellular carcinomaPortal vein cancer thrombusArteriovenous fistula
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