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Comparison between chemoembolization combined with radiotherapy and chemoembolization alone for large hepatocellular
Wei-Jian Guo1, Er-Xin Yu, Lu-Ming Liu
1Department of Oncology, Xinhua Hospital of Shanghai Second Medical University, 1665 Kongjiang Road, Shanghai 200092, China. guoweijian1@sohu.com
World Journal of Gastroenterology
|August 15, 2003
Summary
Transcatheter arterial chemoembolization (TACE) combined with radiotherapy significantly improves survival rates for large, unresectable hepatocellular carcinoma (HCC). This combination therapy offers a promising treatment option for patients with advanced liver cancer.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a major global health concern, particularly in its advanced stages.
- Large, unresectable HCC poses significant treatment challenges, often with poor prognoses.
- Transcatheter arterial chemoembolization (TACE) is a standard treatment, but its efficacy for large tumors can be limited.
Purpose of the Study:
- To evaluate the effectiveness of combining TACE with radiotherapy for patients with large, unresectable HCC.
- To compare the outcomes of TACE plus radiotherapy against TACE alone in this patient population.
- To identify predictors of survival in patients with large HCC undergoing these treatments.
Main Methods:
- A retrospective study comparing 76 patients treated with TACE and radiotherapy to 89 patients treated with TACE alone.
- Patients were diagnosed with large, unresectable HCC between June 1994 and June 1999.
- Multivariate analysis using the Cox proportional hazards model was employed to assess survival predictors.
Main Results:
- The TACE plus radiotherapy group demonstrated a higher objective response rate (47.4%) compared to TACE alone (28.1%).
- Overall survival rates were significantly improved with combined therapy: 64.0% at 1 year, 28.6% at 3 years, and 19.3% at 5 years, versus 39.9%, 9.5%, and 7.2% respectively for TACE alone.
- Radiotherapy emerged as an independent positive predictor of survival, while tumor extension and Child grade were negative predictors.
Conclusions:
- Transcatheter arterial chemoembolization combined with radiotherapy is a more effective treatment strategy than TACE alone for unresectable large HCC.
- This combined approach represents a promising therapeutic option for improving survival outcomes in patients with advanced HCC.
- Further research into optimizing combined TACE and radiotherapy protocols is warranted.