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. 2004 Aug 1;10(15):2184-9.
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  1 , Li Liu, Long-Hua Chen
Affiliations

Therapeutic effects and prognostic factors in three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

De-Hua Wu et al. World J Gastroenterol. .

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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Figures

Figure 1
Figure 1
Actuarial survival of 94 patients treated with 3D-CRT combined with TACE.
Figure 2
Figure 2
Univariate analysis of age on survival of patients treated with 3D-CRT combined with TACE.
Figure 3
Figure 3
Univariate analysis of Child-Pugh classification on survival of patients treated with 3D-CRT combined with TACE.
Figure 4
Figure 4
Univariate analysis of Okuda stage on survival of patients treated with 3D-CRT combined with TACE.
Figure 5
Figure 5
Univariate analysis of tumor size on survival of pa-tients treated with 3D-CRT combined with TACE.
Figure 6
Figure 6
Univariate analysis of tumor type on survival of patients treated with 3D-CRT combined with TACE.
Figure 7
Figure 7
Univariate analysis of albuminemia on survival of patients treated with 3D-CRT combined with TACE.
Figure 8
Figure 8
Univariate analysis of radiation dose on survival of patients treated with 3D-CRT combined with TACE.
See this image and copyright information in PMC

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