Effects of transcatheter arterial chemoembolization combined with or without radiotherapy on patients with advanced unresectable hepatocellular carcinoma

Objective:To evaluate effects of transcatheter arterial chemoembolization(TACE) combined with or without radiation therapy on patients with advanced unresectable hepatocellular carcinoma.Methods:From July 2005 to June 2008,116 patients with advanced unresectable hepatocellular carcinoma were divided into 2 groups,63 cases were treated with TACE(TACE group),53 cases,were treated with TACE and accelerator(Combined group),53 cases.For TACE,20 mg mitomycin C,1000-1500 mg 5-fluorouracil and 60-80 mg cisplatin were perfused into the hepatic arteries,10-20 mliodized oil was given to emobolized the hepatic arteries,and each patient was treated with 2-3 sessions.For combined group,10MV-X was used,≥95% isodose included PTV,and the total treatment doses was 40-60Gy,3-5 times per week.Average dose of liver 25Gy,V30Gy30%;Results:For TACE group and combined group,the 2 year local control rates were 30.2% and 43.6%,respectively.and 3year local control rates were 24.4%,37.9%,(P0.05).For TACE group,2 and 3 year survival rates were 30.1% and 21.5% respectively,and for combined group,they were 21.5% and 32.6% respectively.There was no significant differences for 2 year survival rates(P=0.056),but there was a statistically significant difference for 3 year survival rates(P=0.034).Combined group was found 2 case with radiation induced liver disease(RILD),TACE group was no one was found with RILD.Conclusion:The efficacy of TACE combined with radiotherapy was better than TACE alone for advanced unresectable hepatocellular carcinoma.The toxicity was similar,and clinically acceptable.