Radiat Oncol J.  2014 Mar;32(1):14-22. 10.3857/roj.2014.32.1.14.

Transcatheter arterial chemoembolization and radiation therapy for treatment-naive patients with locally advanced hepatocellular carcinoma

• Kim SW
• Oh D
• Park HC
• Lim DH
• Shin SW
• Cho SK
• Gwak GY
• Choi MS
• Paik YH
• Paik SW

• KMID: 2051152
• DOI: http://doi.org/10.3857/roj.2014.32.1.14

Abstract

PURPOSE
To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT) in treatment-naive 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 alpha/beta = 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-naive patients with locally advanced HCC. A prospective randomized trial is needed to validate these results.

Keyword

Hepatocellular carcinoma; Transcatheter arterial chemoembolization; Radiotherapy

MeSH Terms

Carcinoma, Hepatocellular*
Humans
Liver
Liver Neoplasms
Radiotherapy
Retrospective Studies