Liver Cancer
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 1, 2004; 10(15): 2184-2189
Published online Aug 1, 2004. doi: 10.3748/wjg.v10.i15.2184
Therapeutic effects and prognostic factors in three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma
De-Hua Wu, Li Liu, Long-Hua Chen
De-Hua Wu, Long-Hua Chen, Department of Radiation Oncology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, Guangdong Province, China
Li Liu, Department of Pathology, First Military Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Natural Science Foundation of Guangdong Province, No. 013056
Correspondence to: Dr. Long-Hua Chen, Department of Radiation Oncology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, Guangdong Province, China. flclh@fimmu.com
Telephone: +86-20-61642136 Fax: +86-20-61642131
Received: December 10, 2003
Revised: December 23, 2003
Accepted: February 1, 2004
Published online: August 1, 2004
Abstract

AIM: To evaluate the therapeutic efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with transcatheter arterial chemoembolization (TACE) on the patients with hepatocellular carcinoma (HCC).

METHODS: Between 1998 and 2001, 94 patients with HCC received 3D- CRT combined with TACE. A total 63 patients had a Okuda stage I lesion and 31 patients had stage II. The median tumor size was 10.7 cm (range 3.0-18 cm), and liver cirrhosis was present in all the patients. There were 43 cases of class A and 51 class B. TACE was performed using lipiodol, 5-fluorouracil, cisplatin, doxorubicin hydrochloride and mitomycin, followed by gelatin sponge cubes. Fifty- nine patients received TACE only one time, while the others 2 to 3 times. 3D-CRT was started 3-4 wk after TACE. All patients were irradiated with a stereotactic body frame and received 4-8 Gy single high-dose radiation for 8-12 times at the isocenter during a period of 17-26 d (median 22 d).

RESULTS: The median follow-up was 37 mo (range 10-48 mo) after diagnosis. The response rate was 90.5%. The overall survival rate at 1-, 2-, and 3- year was 93.6%, 53.8% and 26.0% respectively, with the median survival of 25 mo. On univariate analysis, age (P = 0.026), Child-Pugh classification for cirrhosis of liver ( P = 0.010), Okuda stage (P = 0.026), tumor size (P = 0.000), tumor type (P = 0.029), albuminemia (P = 0.035), and radiation dose (P = 0.000) proved to be significant factors for survival. On multivariate analysis, age (P = 0.024), radiation dose (P = 0.001), and tumor size (P = 0.000) were the significant factors.

CONCLUSION: 3D-CRT combined with TACE is an effective and feasible approach for HCC. Age, radiation dose and tumor size were found to be significant prognostic factors for survival of patients with HCC treated by 3D-CRT combined with TACE. Further study for HCC is needed to improve the treatment efficacy.

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