Unresectable hepatocellular carcinoma treated with radiotherapy and/or chemoembolization
J Chia-Hsien Cheng1, V P Chuang, S H Cheng
1Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. jasoncheng@mail.kfcc.org.tw
International Journal of Cancer
|July 28, 2001
Summary
Transcatheter arterial chemoembolization (TACE) with or without radiotherapy shows promising results for unresectable hepatocellular carcinoma (HCC). Combined TACE and radiotherapy (TACE+RT) yielded similar survival to TACE alone, but with increased extrahepatic progression.
Area of Science:
- Hepatobiliary cancers
- Interventional oncology
- Radiation oncology
Background:
- Unresectable hepatocellular carcinoma (HCC) presents a significant treatment challenge.
- Conventional therapies often have limitations in efficacy and toxicity.
- Exploring combined treatment modalities is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and toxicity of transcatheter arterial chemoembolization (TACE) and radiotherapy (RT) for unresectable HCC.
- To compare outcomes between TACE alone, RT alone, and combined TACE+RT.
- To analyze patterns of failure, including local control and extrahepatic progression.
Main Methods:
- Retrospective analysis of 42 patients with unresectable HCC.
- Treatment groups included TACE alone (16 patients), RT alone (9 patients), and combined TACE+RT (17 patients).
- Radiation doses averaged 46.9 Gy; TACE involved Lipiodol, doxorubicin, cisplatin, mitomycin C, and embolization.
Main Results:
- TACE+RT and TACE groups had comparable two-year survival rates (58% vs. 56%).
- Local tumor control was similar between TACE+RT and TACE groups.
- Extrahepatic progression-free survival was significantly worse in the TACE+RT group (36% vs. 100% at two years).
Conclusions:
- Adding local radiotherapy to TACE for unresectable HCC did not improve survival compared to TACE alone.
- Combined TACE+RT showed promising control of treated tumors, even large ones.
- Increased risk of extrahepatic metastasis was observed with combined TACE+RT, necessitating careful patient selection.
