Efficacy and safety analysis of high intensity focused ultrasound ablation combined with hepatic arterial chemoembolization in the treatment of primary hepatocellular carcinoma

doi:10.3877/cma.j.issn.1674-3946.2025.01.016.

Abstract

Abstract:

Objective

To investigate the efficacy and safety of high intensity focused ultrasound ablation （HIFU） combined with hepatic arterial chemoembolization （TACE） in the treatment of primary liver cancer （PLC）.

Methods

The clinical data of 133 patients with PLC from March 2020 to February 2022 were retrospectively analyzed.According to different treatment methods， 65 patients were treated with TACE alone（control group） and 68 patients were treated with HIFU combined with TACE （combination group）.The data were processed by SPSS 25.0 software， and the statistical data of disease remission rate and complications were analyzed by χ² test.Tumor marker data were expressed as （x± s） and independent sample t test was performed.Rank Sum test was used for CNCL staging and Child-Pugh classification.Kaplan-Meier was used to draw the survival curve.P ＜ 0.05 indicated that the difference was statistically significant.

Results

The objective response rate （ORR） in combination group was 82.4% higher than that in control group 66.2% （P ＜ 0.05）.There was no significant difference in disease control rate （DCR） between the two groups （P ＞ 0.05）.After

treatment， serum alpha-fetoprotein （AFP）， α-L-fucoidase （AFU） and abnormal prothrombin Ⅱ （PIVKA-Ⅱ）in 2 groups were lower than before treatment， and the combined group was lower than the control group （P ＜ 0.05）.The incidence of abdominal pain in combination group was higher than that in control group （P ＜ 0.05）.There was no significant difference in overall survival time （OS） between the two groups （P ＞ 0.05）.The progression-free survival time （PFS） of the combined group was longer than that of the control group （P ＜ 0.05）.

Conclusion

HIFU combined with TACE in the treatment of PLC can improve the remission rate， reduce the level of tumor markers， prolong the time of tumor progression， but increase the risk of abdominal pain.

Key words: Liver Neoplasms, Carcinoma, Hepatocellular, High Intensity Focused Ultrasound, Transcatheter Arterial Chemoem-Bolization, Postoperative Complications, Biomarkers, Tumor

Xiaowei Chang, Yu Cai, Zhiyong Zhao, Wei Zhang. Efficacy and safety analysis of high intensity focused ultrasound ablation combined with hepatic arterial chemoembolization in the treatment of primary hepatocellular carcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 56-59.

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Figures/Tables 5

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）
联合组	68	55.8±8.3	58/10	3.9±0.7
对照组	65	58.3±8.9	50/15	4.1±0.8
t/χ²/Z值		1.636	1.526	1.861
P值		0.106	0.217	0.065
组别	例数	CNLC分期（例）Ⅰ/Ⅱ/Ⅲa	肿瘤数量（例）≥3/＜3	Child-Pugh分级（例）A级/B级
联合组	68	23/37/8	23/45	28/40
对照组	65	17/35/13	18/47	34/31
t/χ²/Z值		2.079	0.586	1.282
P值		0.354	0.444	0.200

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）
联合组	68	55.8±8.3	58/10	3.9±0.7
对照组	65	58.3±8.9	50/15	4.1±0.8
t/χ²/Z值		1.636	1.526	1.861
P值		0.106	0.217	0.065
组别	例数	CNLC分期（例）Ⅰ/Ⅱ/Ⅲa	肿瘤数量（例）≥3/＜3	Child-Pugh分级（例）A级/B级
联合组	68	23/37/8	23/45	28/40
对照组	65	17/35/13	18/47	34/31
t/χ²/Z值		2.079	0.586	1.282
P值		0.354	0.444	0.200

组别	例数	CR	PR	SD
联合组	68	32（47.1）	24（35.3）	9（13.2）
对照组	65	23（35.4）	20（30.8）	17（26.2）
χ²值		-	-	-
P值		-	-	-
组别	例数	PD	ORR	DCR
联合组	68	3（4.4）	56（82.4）	63（92.6）
对照组	65	5（7.7）	43（66.2）	60（92.3）
χ²值		-	4.583	0.185
P值		-	0.032	0.667

组别	例数	时间	AFP（ng/ml）	AFU（U/L）	PIVKA-Ⅱ（mAu/ml）
联合组	68	治疗前	542.8±204.5	83.7±23.4	336.3±63.6
联合组	68	治疗后	92.3±16.8^ab	18.8±4.3^ab	48.5±9.3^ab
对照组	65	治疗前	510.7±234.7	86.2±21.5	353.1±58.7
对照组	65	治疗后	142.5±23.3^a	27.4±5.5^a	65.6±13.4^a

组别	例数	肝功能异常	皮肤损伤	腹痛	恶心呕吐	发热
联合组	68	5（7.4）	4（5.9）	23（33.8）	8（11.8）	2（3.1）
对照组	65	2（3.1）	0（0.0）	12（18.5）	5（7.7）	0（0.0）
χ²值		0.512	2.183	4.045	0.671	0.434
P值		0.474	0.140	0.044	0.413	0.510

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