Clinical effect of transcatheter arterial chemoembolization combined with high intensity focused ultrasound ablation in treatment of large hepatocellular carcinoma

Objective: To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with high intensity focused ultrasound (HIFU) ablation in treatment of large hepatocellular carcinoma (HCC).

Methods: Sixty-eight patients with unresectable HCC were randomized into 2 age, tumor size, TNM stages, and liver function grade-matched groups: TACE group (n=30) undergoing TACE and TACE+HIFU group (n=38) undergoing 2-3 weeks after TACE. A total of 88 tumors (9.3+/-3.2) (5.0-14.5) cm in diameter were detected, and the largest tumor in a specific patients with multiple lesions was selected for observation. Follow-up was conducted for (13+/-7) (3-24) months to observe the necrosis of tumor, size of tumor, local recurrence, and survival of patient.

Results: The clinical symptom remission rate was 90.6% (29/32) in the TACE+HIFU group and 70.8% (28/38) in the TACE group. The tumor necrosis and minification rates of the TACE+HIFU and TACE groups were 73.7% and 68.4% respectively, both significantly higher than those of TACE group (26.7% and 33.3% respectively, both P<0.01). The tumor local recurrence rate of the TACE+HIFU group was 21.1%, not significantly different from that of the TACE group (33.3%, P>0.05). The median survival duration of the TACE+HIFU group was 18 months, significantly longer than that of the TACE group (10 months, P<0.05).

Conclusions: Compared with the TACE therapy alone, the combination therapy improves the tumor necrosis rate and prolongs the patients' survival duration.