Evaluation of efficacy of transcatheter arterial chemoembolization combined with high intensity focused ultrasound in the treatment of massive hepatocellular carcinoma complicated with portal vein tumor thrombosis

Abstract:

Objective：To evaluate the short-term clinical efficacy of transcatheter arterial chemoembolization（TACE） combined with high intensity focused ultrasound（HIFU） in the treatment of massive hepatocellular carcinoma（MHCC） complicated with portal vein tumor thrombosis（PVTT）. Methods：A total of 81 patients with MHCC complicated with PVTT in the Second Affiliated Hospital of Chongqing Medical University were enrolled in this retrospective study. According to the treatment methods，they were divided into the TACE+HIFU group（41 patients，received TACE combined with HIFU） and the TACE group（40 patients，only received TACE）. The effective treatment rate was evaluated by comparing the imaging data of tumor lesions and PVTT in two groups，and the survival quality Karnofsky score，postoperative adverse reactions and median survival time were analyzed. Pearson correlation was used to analyze the relationship between time interval of HIFU treatment after TACE and Karnofsky score one month after op－eration. Results：The tumor lesion and PVTT effective rate in the TACE+HIFU group（58.5%；48.8%） was significantly higher than that in the TACE group（20.0%；17.5%），and the difference between the two groups was statistically significant（P=0.000，0.003）. The median survival time in the TACE+HIFU group was 8 months，which was longer than that in the TACE group（4 months）（P=0.028）. The Karnofsky score one month after operation in the TACE+HIFU group was higher than that before operation；the quality of life was improved，which was better than that in the TACE group（P=0.009）. There were no serious complications in both groups during the postoperative and follow-up period. The time interval of HIFU treatment after TACE showed a low negative correlation with Karnofsky score one month after operation（r=-0.381，P=0.014）. Conclusion：For patients with MHCC and PVTT，the pattern of TACE+HIFU is a safe and effective combination therapy，enhancing the short-term curative effect. It not only can prolong survival time，but also control the progression of the tumor lesion and PVTT at the same time.