Effects of gamma knife stereotaxis radiation therapy combined with transcatheter arterial chemoembolization on patients with advanced unresectable hepatocellular carcinoma

Objective:To eveluate effects of body gamma knife stereotaxis radiation therapy combined with transcatheter arterial chemoembolization(TACE)on patients with advanced unresectable hepatocellular carcinoma.Methods:Sixteen patients were treated by gamma knife and TACE(Combined group).For gamma knife stereotaxis radiation therapy,planning of treatment from 3 to 10 dots,3-6Gy per-fraction,2-5 times per week,and the total treatment dose was 30-50Gy.≥50% isodose include PTV.Average dose of liver25Gy,V30Gy30%.For TACE,20 mg mitomycin C,1000-1500 mg 5-fluorouracil and 60-80 mg cisplatin were perfused into the hepatic arteries,10-20 ml iodized oil were given to emobolized the hepatic arteries,and each patient was treated with 1-2 sessions.Sixteen patients were treated only by gamma knife(Gamma knife group).Results:The response rates(CR+PR)were 75.0%(12/16)and 56.3% for Combined group and Gamma knife group,the difference of the response rate was statistically significant(P0.005).For Combined group,the 1 and 2 year survival rates were 70.2% and 41.6% respectively,and for Gamma knife group,they were 58.6% and 27.3% respectively.The differences were statistically significant for 1 and 2 year survival rates(P0.05).Conciusion:Gamma knife combined with TACE is an effective approach in the treatment of advanced unresectable hepatocellular carcinoma.