Abstract: Objective To investigate the efficacy and safety of super-selective hepatic arterial chemoembolization (S-TACE) combined with apatinib in patients with advanced primary liver cancer (HCC). Methods In recent years, 72 patients with advanced HCC were divided into two groups. The control group was treated with S-TACE, and the observation group was treated with S-TACE combined with apatinib. The changes of tumor vascular inflammatory factors, liver function, therapeutic effect and safety indexes in the two groups were observed. Results Before treatment, the levels of tumor vascular factors such as VEGFR2, mmp-9 and caspase-8, as well as the levels of liver function indexes such as AFP-L3,ALT ,and LDH in the two groups were not statistically significant (P>0.05). After the treatment, the levels of tumor vascular factors and liver function indexes in the observation group were improved compared with those in the control group, which was statistically significant (P<0.05). The ORR and DCR in the observation group were higher than those in the control group, while MTTP and MOS were higher than those in the control group, which was statistically significant (P<0.05). There was no significant difference in the postembolization syndrome between the two groups (P>0.05). The adverse drug reactions in the observation group were higher than those in the control group, which was statistically significant (P>0.05). Conclusion For patients with advanced HCC, S-TACE combined with apatinib therapy can inhibit tumor angiogenesis, improve liver function, improve clinical benefit rate and provide high safety.

Key words: Primary liver cancer, S-TACE, Apatinib, Tumor vascular factor, security