Clinical study of transcatheter arterial chemoembolization combined with γ-knife for primary hepatic carcinoma

Objective To observe the reponse and tolerance of patients with primary hepatic carcinoma(PHC) treated by gamma knife combined with transcatheter arterial chemoembolization(TACE) and compare the efect of TACE alone with that of TACE combined with stereotactic body radio therapy(SBRT) for patients with primary hepatic carcinoma.Methods A total of 56 patients with HCC were randomly divided into TACE alone group and TACE combined with SBRT group.22 cases of the 56 patients were treated with TACE alone and 34 with TACE plus 3DCRT.34 patients were treated with TACE firstly,TACE was performed using lipiodol,Oxaliplatin,HCPT,MMC,5-FU,followed by gelatinspong cubes,gamma ray conformal radiotherapy was performed after 1-3 times TACE was given,50% isodose include PTV,dosage of 400-450cGy/fractions,6 times one week,a total of 10-13 fractions was used,total dose intumor margins was 45-52Gy.Results The total effective rate after three months and overall survival rates after 1,3,5 years in TACE combined with SBRT group(79.4%,82.3%,52.9%,20.6%)were significantly higher than that in TACE alone group(50.0%,59.1%,31.8%,9.1%)(P0.05).Conclusion TACE combined with γ-knife is an effective local treatment for the primary hepatocellular carcinoma.The therapeutic effect with TACE combine SBRT much is better than TACE alone.