EVALUATION OF THE THERAPEUTIC EFFECT OF TAE ON PRIMARY LIVER-CANCER

The therapeutic effect of transcatheter arterial chemoembolization (TA E) performed on 31 patients with primary liver cancer was evaluated us ing the following procedures: (1) the alpha-fetoprotein (AFP) reductio n rates and prognoses were analyzed according to the tumor reduction r ates (TR), and (2) the AFP reduction rates and prognoses were also ana lyzed according to the tumor necrosis rates (TN) estimated by regardin g every region with Lipiodol retention as being necrotic. The followin g results were obtained. The AFP level was 400 ng/ml or higher in 15 p atients (48%). Their AFP reduction rates were as favorably high as 65. 4%-99.8% (mean, 88.1%), and the AFP level was normalized in 3 patients . The cumulative survival rates after the initial treatment were relat ively high, i.e., 78.4% in the Ist year, 58.1% in the 2nd year, and 38 .7% in the 3rd year. These results suggested the effectiveness of the TAE treatment undertaken in this study. Regarding the TR, the tumor wa s reduced in size by 50% or more in only 5 patients (16%), and most pa tients had a TR of less than 25%. On the other hand, the majority, 25 patients (81%), had a TN ranging between 50% and less than 100%, inclu ding 7 who had a TN ranging between 50% and less than 90% and 18 who h ad a TN ranging between 90% and less than 100%. There was no significa nt correlation between the AFP reduction rate and the TN or TR. Regard ing evaluation of the cumulative survival rates by TR and TN, the 1-ye ar survival rate was lower in patients having a TR of less than 25% th an in those having a TR of 25% or more. Patients having a TN of less t han 50% showed a poor outcome as compared with those having a TN of 50 % or more. Although the TR was found to be less than 50% in a majority of the patients when the therapeutic effect of TAE on the liver cance r was evaluated according to the TR, many of these patients showed a g ood outcome. Thus, the conventional efficacy evaluation, in which a tu mor reduction of 50% or more is considered to be effective, should be reconsidered. On the other hand, the TN was found to be 50% or more in most of the patients, suggesting the necessity of a more detailed cla ssification of TN. In relation to the survival rate, patients having a TN of less than 50% showed a poor outcome.