Objective To evaluate the therapeutic efficacy and safety of transcatheter artery chemoembolization (TACE) combined with percutaneous intratumoral injection of Lipiodol emulsion of pirarubicin in treating advanced hepatocellular carcinoma (HCC). Methods Eighty cases with advanced primary HCC were randomly divided into two groups. Patients in TACE group (n = 34) were treated with simple TACE, and patients in combination therapy group (n = 46) were treated with TACE together with percutaneous intratumoral injection of Lipiodol emulsion of pirarubicin. All patients were followed up for 6-36 months. Postoperative adverse effects and complications were recorded. CT scanning, AFP level and hepatic functions were reexamined. The survival rate was calculated. The results were compared between the two groups. Results No significant difference in the incidence of adverse effects and complications existed between the two groups (P > 0.05). The mean decreasing amount of AFP level in combination therapy group was 78.6%, which was significantly higher than that in simple TACE group (56.1%) with P < 0.05. The effective remission rate (CR + PR) in combination therapy group was 69.6%, which was significantly higher than that in simple TACE group (55.9%) with P < 0.05. In both groups significant difference in hepatic functions existed between preoperative data and postoperative ones (P < 0.05), while no significant difference in preoperative as well as in postoperative hepatic functions existed between the two groups (P > 0.05). The one-year and two-year survival rates of the combination therapy group were 65.2% and 45.7% respectively,which were significantly higher than those of simple TACE group (38.2% and 26.7% respectively, P < 0.05). The difference in three-year survival rate between the two groups was not significant (P > 0.05). Conclusion For the treatment of advanced HCC, TACE combined with percutaneous intratumoral injection of Lipiodol emulsion of pirarubicin is safe and effective, and its clinical therapeutic efficacy is better than that of simple TACE.%目的 探讨肝动脉化疗栓塞术(TACE)联合经皮肝穿瘤内注射碘油吡柔比星乳剂治疗中晚期肝癌的疗效及安全性.方法 80例中晚期原发性肝癌患者分为两组:TACE组单纯行TACE治疗,34例；联合治疗组采取TACE结合经皮瘤内注射碘油吡柔比星乳剂治疗,46例.术后观察、比较两组不良反应及并发症发生情况,复查CT、AFP、肝功能,并随访分析生存率.结果 两组不良反应及并发症的发生率比较差异无统计学意义(P＞0.05)；联合治疗组AFP总下降幅度为78.6％,优于TACE组56.1％(P＜0.05)；联合治疗组有效率RR(CR+ PR)为69.6％,高于TACE组55.9％(P＜ 0.05)；治疗前、后两组肝功能比较差异有统计学意义(P＜0.05),治疗前、后两组间肝功能比较差异无统计学意义(P＞ 0.05)；联合治疗组1、2年生存率为65.2％和45.7％,明显高于TACE组(1、2年生存率为38.2％和26.7％)(P＜0.05),两组3年生存率比较差异无统计学意义(P＞0.05).结论 TACE结合经皮瘤内注射碘油吡柔比星乳剂治疗中晚期肝癌安全、有效,优于单纯动脉化疗栓塞治疗.
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