Effect of ultrasound- guided percutaneous injection of cinobufotalin or anhydrous ethanol in treatment of portal vein tumor thrombus: a comparative analysis

To investigate the effect of ultrasound- guided percutaneous injection of cinobufotalin or anhydrous ethanol in the treatment of portal vein tumor thrombus( PVTT) through a comparative analysis. Methods A total of 56 patients with PVTT after liver cancer surgery,who were admitted to the 94 th Hospital of PLA from October 2009 to December 2011,were enrolled. Among these patients,27 underwent ultrasound-guided percutaneous injection of cinobufotalin( cinobufotalin group) and 29 underwent ultrasound- guided percutaneous injection of anhydrous ethanol( anhydrous ethanol group). The clinical outcome and survival time were compared between the two groups after treatment,and the levels of total bilirubin( TBil),alanine aminotransferase( ALT),and aspartate aminotransferase( AST) before and after treatment were compared. The t- test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,the rank sum test was used for comparison of ranked data,and the Kaplan- Meier method was used for survival analysis. Results The response rate showed no significant difference between the cinobufotalin group and the anhydrous ethanol group( 63. 0% vs 58. 6%,χ~2= 0. 111,P > 0. 05). After treatment,the cinobufotalin group had significantly lower levels of TBil,ALT,and AST than the anhydrous ethanol group( t = 2. 24,2. 40,and 2. 39,all P < 0. 05). The 6- month,1- year,and 2- year survival rates showed no significant differences between the cinobufotalin group and the anhydrous ethanol group( 81. 5% /63. 0% /29. 6% vs 82. 8% /58. 6% /31. 0%,χ~2= 0. 016,0. 111,and 0. 013,all P > 0. 05). Conclusion Ultrasound- guided percutaneous injection of cinobufagin or anhydrous ethanol has similar short-and long- term effects in the treatment of PVTT and can inhibit the growth of tumor thrombus and prolong survival time,but cinobufagin is superior to anhydrous ethanol in the aspect of protecting liver function.