Analysis of clinical effect of drug-loaded microsphere embolization in the treatment of primary liver cancer after TIPS

CHEN Jing; CAO Liming; CUI Jinguo; KANG Zhilong; WANG Ying; ZHOU Wei

Abstract：Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization with drug-loaded micro-spheres in the treatment of primary liver cancer after transjugular intrahepatic portosystemic shunt(TIPS).Methods The clini-cal data of 20 patients with primary liver cancer after TIPS were treated with DEB TACE in our hospital were retrospectively ana-lyzed.Modified solid Tumor Efficacy Evaluation Criteria(mRECIST)was used to evaluate the therapeutic effect after emboliza-tion,and the changes of liver function and adverse reactions before and after embolization were compared.Results TIPS exam-ined by ultrasound or contrast before DEB TACE treatment was patency in 20 patients,and a total of 32 times of DEB TACE treatment were performed,with the technical success rate of 100%.According to mRECIST evaluation criteria,the objective dis-ease response rates(ORR)at 1,3 and 6 months after DEB-TACE treatment were 90%,70%and 65%,and the disease control rates(DCR)were 95%,80%and 80%,respectively.On day 3 and day 7 after DEB-TACE treatment,the main liver function in-dexes of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and bilirubin were significantly higher than before,with statistical significance(P<0.05).And gradually recovered to normal 15 days after operation,and there was no statistical dif-ference compared with that before operation(P>0.05).There were no significant changes in albumin and blood ammonia levels.Postoperative adverse reactions were mainly fever,abdominal pain,nausea and vomiting,and no liver abscess,hepatic encepha-lopathy,and liver failure occurred.Conclusion The short-term efficacy of DEB-TACE in the treatment of primary liver cancer after TIPS is safe and reliable,and the long-term efficacy needs to be studied further.