Abstract:

Objective To compare the efficacy and safety of different chemotherapy regimens used in TACE for the treatment of primary liver cancer. Methods 136 patients with primary liver cancer who had received transcatheter arterial chemoembolization（TACE）from January 2012 to January 2019 in our center were selected. Patients were divided into group A and group B according to different chemotherapy regimens in TACE. Group A received chemotherapy regimen with fluorouracil 1 000 mg plus oxaliplatin 100 mg and pirarubicin 40 mg，which was partially emulsified with lipiodol and then for embolization，and partially perfused through superior mesenteric artery and hepatic artery. In group B，oxaliplatin 100 mg was emulsified with lipiodol for embolization. Objective re⁃ sponse rate（ORR），disease control rate（DCR），and progression⁃free survival（PFS）were used to evaluate the effectiveness of the therapies；the incidence of serious complications was used to assess the safety. Results A total of 136 patients met the inclusion criteria，including 98 in group A and 38 in group B. There were no significant differences in the baseline characteristics between the two groups. The ORR was 53.1 %（52/98）in group A and 36.8%（14/38）in group B，and the difference was not statistically significant（χ2 = 2.884，P = 0.089）. The DCR was 82.7 %（81/98）in group A and 71.1 %（27/38）in group B，and the difference was not statistically significant （χ2 = 2.254，P = 0.133）. The median PFS was 192 days（95%CI：152~231）in group A and 183 days（95%CI： 60~305）in group B，and the difference was not statistically significant（χ2 = 1.081，P = 0.299）. Multivariate regression analysis showed that the only independent risk factor for PFS was extrahepatic metastasis（HR = 2.283， 95%CI：0.25 ~ 0.77，P = 0.004）. The incidence of serious adverse reactions was 15.3 %（15/98）in group A and 2.6%（1/38）in group B，and the difference was statistically significant（P = 0.04）. Conclusions The efficacy of TACE with low⁃dose monotherapy for primary liver cancer is the same as that of TACE with high⁃dose polytherapy. For the low⁃dose monotherapy，the incidence of complications is reduced and the safety of therapies is improved.

Key words:

primary liver cancer, transcatheter arterial chemoembolization, chemotherapy regimens, dosage, safety