Three-dimensional conforntal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinome

Objective To evaluate the response and tolerance in the hepatocellular carcinoma patients by three-dimensional conforntal radiotherapy combined with transcatheter arterial chemoembolization.Methods From 2002 to 2005,66 cases with hepatocellular carcinoma were enrolled into this study,34 patients and 32 patients were randomly divided into transcatheter arterial chemoembolization combined with three-dimensional conforntal radiotharapy group(TACE/3DCRT)and transcatherter arterial chemoembolization alone group(TACE)respectively.TACE/3DCRT group patients underwent TACE 2 courses.Then they received 3DCRT after an interval of about one month.The total radiation dose was 45～55Gy,in daily 2～5Gy fractions,with 5 fractins in week.TACE group received 4 cycles of treatment with transcatheter arterial chemoembolization.The efficacy and toxicity were evaluated according to WHO standard.Results The overall response rate was 76.5%(CR0,PR26)in TACE/3DCRT group of 34 cases and 46.9%(CR0,PR15)in TACE group of 32 cases.The difference in response rate was statistically significant between the two groups(χ2=6.136,P0.05).The survival rate of 1 year was 61.8%in TACE/3DCRT group and 46.9% in TACE group(χ2=1.474,P0.05),no significance existed.The survival rate of 2 years was 41.2% in TACE/3DCRT group and 18.8% in TACE group(χ2=3.926,P0.05),the survival rate of 3 years was 29.4% in TACE/3DCRT group and 6.3% in TACE group(χ2=5.945,P0.05),significance existed.But the difference treatment-releted toxicitied between these two groups were not significant.Conclusion TACE combined with 3DCRT is an effective and feasible aproach with minimal trauma in treatment of hepatocellular carcinoma.