Clinical analysis of γ-knife combined with interventional chemotherapy for patients with liver carcinoma

Objective:To analyze the reponse and tolerance of patients with hepatocellular carcinoma(HCC)treated by γ-ray three-dimensional fractionated stereotactic conformal radiotherapy(FSCR)combined with transcatheter arterial chemoembolization(TACE),and to compare effect of the transcatheter arterial chemoembolization(TACE)alone with that of TACE combined with FSCR for patients with primary or metastasis liver carcinoma.Methods:A total of 94 patients with HCC were randomly divided into TACE alone group and TACE combined with FSCR group.Fifty of the 94 patients who were treated with TACE alone and forty-four were treated with TACE plus FSCR.thirty-nine of the 44 patients were treated with TACE firstly,TACE was performed using lipiodol,cisplatin,followed by gelatin spong cubes,γ-ray conformal radiotherapy was performed after 1-3 times TACE was given,50%-70% isodose include PTV,dosage of 4-5Gy/fractions,3 times one week,a total of 9-12 fractions was used,total dose in tumor margins was 40-60Gy.Five of the 44 patients were treated with TACE for 1-3 times after γ-ray conformal radiotherapy 2-3 weeks.Cox proportional hazard model was used to analyze the prognostic factors.Results:The total effective rate after three months and overall survival rates after 1,3,5 years in TACE combined with FSCR group(77.2%,70.4%,43.2%,20.5%)were significantly higher than that in TACE alone group(52.0%,46.0%,14.0%,8.0%,P0.05).Conclusion:γ-ray conformal radiotherapy combined with transcatheter arterial chemoembolization(TACE)was a safe and effective trentment for liver cancer.In TACE combined with FSCR group,the number and diameter of tumor,child-pugh classification were the key factors in clinical prognosis.