Abstract: Background and purpose: Transcatheter arterial chemoembolization (TACE) is still the first choice for patients with primary liver cancer which disagree with or lose the chance of surgery. High intensity-focused ultrasound (HIFU) has already achieved a certain effect in the treatment of primary liver cancer. However, the effect of the two combined use is not clear. The purpose of this study was to investigate the therapeutic effects of TACE combined with HIFU and the sole TACE in treating primary liver cancer. Methods: With the method of retrospective analysis, 121 patients suffering from primary liver cancer were selected from the Second Affiliated Hospital of Chongqing Medical University from Jan. 2015 to Aug. 2016. They were divided into two groups, including the TACE combined HIFU group (experimental group) with 55 patients and the sole TACE group (control group) with 66 patients. The postoperative clinical effects, postoperative adverse reactions, the survival rates of 1 year and the progression-free survival were compared between these two groups. Results: The propensity score matching method was used to balance the covariates between the two groups, and the imbalance of alpha-fetoprotein (AFP) levels and with or without portal venous tumor emboli between two groups were balanced after matching. After matching, the 1-year survival rate of HIFU group was 94.0%, which was higher than that of the TACE group (75.0%), and the difference was statistically significant (P<0.05). There was no difference between the two groups in the progression-free survival (P>0.05). Conclusion: Compared with sole TACE, TACE combined with HIFU can improve the 1-year survival rate of patients with primary liver cancer.

Key words: High intensity focused ultrasound, Transcatheter arterial chemoembolization, Combined treatment, Primary liver cancer, Propensity score matching