Abstract: Objective To analyze the effect of iodized oil via hepatic arterial chemoembolization (C-TACE) sequential microwave ablation therapy combined with lenvatinib in the treatment of advanced hepatocellular carcinoma (HCC). Methods The medical records of 105 unresectable patients with advanced HCC admitted to Hanzhong Central Hospital from February 2019 to January 2022 were retrospectively analyzed. The patients were divided into a control group (n=51, C-TACE sequential microwave ablation) and an observation group (n=54, Lenvatinib combined with C-TACE sequential microwave ablation) according to different treatment regimens.Tumor markers, adverse reactions, liver function indexes, survival and clinical efficacy [i.e., disease control rate (DCR) and objective response rate (ORR)] were compared between the two groups. Results The DCR and ORR in the observation group were 81.48% and 48.15%, respectively, which were higher than those of 60.78% and 24.45% in the control group (P<0.05). After treatment, the serum levels of carcinoembryonic antigen (CEA), aspartate aminotransferase (AST), α-L-fucosidase (AFU), total bilirubin (TBil), alpha-fetoprotein (AFP) and alanine aminotransferase (ALT) in both groups were decreased (P<0.05), but the values of the observation group were lower than those of the control group (P<0.05). The survival rate of observation group was 70.37%, which was higher than that of the control group (50.98%) (P<0.05). There was no difference in adverse reactions between the two groups (P>0.05). Conclusion C-TACE sequential microwave ablation combined with lenvatinib in the treatment of unresectable middle and advanced HCC patients is effective, as indicated by reducing the levels of tumor markers, good safety, and improving liver function and prognosis of the patients.

Key words: Iodized oil transhepatic arterial chemoembolization, Microwave ablation, Lenvastinib, Hepatocellular carcinoma, Not excision, Security, Clinical effect