[External radiation and combined transcatheter arterial chemoembolization for unresectable primary liver cancer]

Transcatheter arterial chemoembolization (TACE) is the routine treatment for unresectable primary liver cancer, but 3-year survival rate of patients received TACE alone is only about 20%. This research was to evaluate efficacy of external radiotherapy (RT) combined with TACE on unresectable primary live cancer.

From Jun. 1994 to Apr. 2002, 114 patients with unresectable primary liver cancer were non-randomized to receive TACE plus RT (54 patients), or TACE alone (60 patients) as control. For TACE, after skiagram confirmed catheterization, suspension of 300 mg of carboplatin, 50-60 mg of epirubicin, 14-20 mg of mitomycin, and 10-30 ml of iodized oil was perfused into hepatic arteries, 1-2 mm of Gelfoam particles was given to embolize hepatic arteries according to blood supply conditions of tumors, this process was repeated every 4-8 weeks. Either group was treated with 1-4 sessions of TACE. In TACE+RT group, patients received radiation on tumor and generous margin 21-28 days after TACE. The radiation dose was 46-60 Gy in daily 2 Gy fractions.

In TACE+RT group, response rate (AFP titer decrease of >50%) was 61.1%, and 1-, 2-, 3-year survival rates of TACE+RT group were significantly higher than those of TACE group (66.5% vs. 53.9%, 48.4% vs. 37.2%, and 37.4% vs. 17.8%, P<0.05). Three-year survival rate correlated with tumor size, liver function grade, and portal vein embolus.

TACE combined with RT may prolong survival time of patients with unresectable primary live cancer.