Transcatheter arterial chemoembolization combined with percutaneous injection of ethanol-lipiodol mixture for treatment of hepatocellular carcinoma: a non-randomized controlled study of 122 cases

The aim is to evaluate effects and safety of the combination of transcather arterial chemoembolization (TACE) and percutaneous ethanol-lipiodol injection (PELI) for the treatment of unresectable hepatocellular carcinoma (HCC). A total of 122 patients (104 men and 18 women; mean age: 52 years old) with histopathologically proven HCC were consecutively enrolled for either the combination of TACE with PELI (the combo group) or TACE alone (the control group). Safety and toxicity of the combination therapy, and its effects on survival rates, progression-free survival (PFS), and local response were evaluated. Patients in the combo group had better local response than those in the control group had in stage II disease. Objective response rate in stage I, II and III disease was 84.6%, 78.6% and 59.3% in the combo group, and 66.7%, 45.8%, 31.0% in the control group, respectively. Both PFS and the cumulative survival curves showed that the combo group had better results than the control group had. In the combo group, PFS curve showed that both stage I and stage II disease had longer PFS than stage III had. Survival curve also showed that better survival rates were observed in stage I than that in stage III disease. The combination of TACE with PELI improved survival time of patients with unresectable HCC compared to TACE alone. Side effects were minor and delay in disease progression was obvious. A further study to better determine the efficacy of this combination therapy is warranted.