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KMID : 1038620140320010014
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Radiation Oncology Journal
2014 Volume.32 No. 1 p.14 ~ p.22
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Transcatheter arterial chemoembolization and radiation therapy for treatment-na?ve patients with locally advanced hepatocellular carcinoma
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Kim Sang-Won
Oh Dong-Ryul
Park Hee-Chul
Lim Do-Hoon
Cho Sung-Ki
Shin Sung-Wook
Gwak Geum-Youn
Choi Moon-Seok
Paik Yong-Han
Paik Seung-Woon
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Abstract
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Purpose: To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT) in treatment-na?ve patients with locally advanced hepatocellular carcinoma (HCC).
Materials and Methods: Eligibility criteria were as follows: newly diagnosed with HCC, the Barcelona Clinic Liver Cancer stage C, Child-Pugh class A or B, and no prior treatment for HCC. Patients with extrahepatic spread were excluded. A total of 59 patients were retrospectively enrolled. All patients were treated with TACE followed by RT. The time interval between TACE and RT was 2 weeks as per protocol. A median RT dose was 47.25 Gy10 as the biologically effective dose using the α/β = 10 (range, 39 to 65.25 Gy10).
Results: At 1 month, complete response was obtained in 3 patients (5%), partial response in 27 patients (46%), stable disease in 13 patients (22%), and progressive disease in 16 patients (27%). The actuarial one- and two-year OS rates were 60.1% and 47.2%, respectively. The median OS was 17 months (95% confidence interval, 5.6 to 28.4 months). The median time to progression was 4 months (range, 1 to 35 months). Grade 3 or greater liver enzyme elevation occurred in only two patients (3%) after RT. Grade 3 gastroduodenal toxicity developed in two patients (3%).
Conclusion: The combination treatment of TACE followed by RT with two-week interval was safe and it showed favorable outcomes in treatment-na?ve patients with locally advanced HCC. A prospective randomized trial is needed to validate these results.
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KEYWORD
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Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Radiotherapy
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