A CLINICAL STUDY OF γ-RAY THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY COMBINED WITH INTERVENTIONAL THERAPY FOR PATIENTS WITH HEPATOCELLULAR PRIMARY OR METASTATIC CARCINOMA

Objective:To evaluate the effect and tolerance of patients with hepatocellular carcinoma(HCC) treated by γ-ray three-dimensional conformal radiotherapy(3-DCRT)combined with transcatheter arterial chemoembolization(TACE),comparing effect of TACE alone with that of TACE combined with 3-DCRT for patients with hepatocellular primary or metastatic carcinoma.Methods:From March 2000 to May 2003,94 patients with HCC were randomly divided into TACE alone group(n=50)and TACE combined with 3-DCRT group(n=44).39 cases were treated with TACE firstly.TACE was performed using lipiodol,cisplatin,followed by gelatin sponge cubes,3-DCRT was performed after 1~3 times of TACE.50%~70% isodose curve include PTV,dosage of 4~5Gy/fractions,3 times/wk,a total of 9~12 fractions was used for the patients,the total doses in tumor margins were 40~60Gy.5 cases were treated with TACE for 1~3 times after given 3-DCRT 2~3 weeks.The COX proportional hazards model was used to analysis the prognostic factors.Results:The total effective rate after three months and overall survival rates after 1,3,5a in TACE combined with 3-DCRT group(77.3%,70.5%,43.2%and 20.5%,respectively)were significantly higher than that in TACE alone group(52.0%,46.0%,14.0% and 8.0% respectively).P0.05.In TACE combined with 3-DCRT group,the number and diameter of the tumor,Child-pugh classification were the key factor in clinical prognosis.Conclution:3-DCRT+ TACE is better than TACE alone for HCC.