Clinical Study Of Transcatheter Arterial Chemoembolization Combined With Three-Dimensional Conformal Radiotherapy In 77 Patients With Primary Hepatic Carcinoma

OBJECTIVE:To evaluate the clinical effect of transcatheter arterial chemoembolization(TACE)combined with three-dimensional conformal radiotherapy(3DCRT)for inoperable primary hepatic carcinoma (PHC).METHODS:Seventy-seven patients with inoperable PHC were received cisplatin(DDP)+ 5-fluorouracil(5-Fu)or cisplatin(DDP)+ epirubicin(EPI) transcatheter arterial perfusion through feeding artery of carcinoma in liver with Seldinger's method as the therapy group,then were received hydroycamptothecin(HCPT)and iodized oil transcatheter arterial embolization. The group received 6oCo-γRadiotherapy splitting three or four weeks after the first or the second cycle of chemotherapy.130 patients with PHC treated in the same period of time with TACE alone served as the control group.The therapeutic effect rates,the rates of AFP reduced to half,survival rates, side-effects and distant metastases of the two groups were assessed.RESULTS:The therapeutic effect rates were 81.82%and 60.00%in the therapy group and the control group,respectively The difference between the two groups was significant(P＜0.05).The rates of AFP reduced to half of its primary level were 55.84%and 34.62%in the therapy group and the control group,respectively.The difference between the two groups was statistically significant(P＜0.05).The overall 1-,2-,3-year survival rate,median survival time,mean survivaltime were78.60%,48.40%,30.70%,23months, 35.17 months in the therapy group,and 54.60%,23.80%,6.20%,13 months, 16.62 months in the control group,respectively.The difference between the two groups was statistically significant(P＜0.05).No severe side-effects and complications found.The difference between the two groups was not statistically significant(P＞0.05).The rate of the patients who developed pulmonary metastases were 11.69%and 9.23%in the therapy group and the control group,respectively The rate of the patients who developed abdominal cavity metastases were 7.79%and 8.46%in the therapy group and the control group,respectively.The difference between the two groups was not statistically significant(P＞0.05).CONCLUSIONS:Transcatheter arterial chemoembolization combined with three-dimensional conformal radiotherapy is more effective than transcatheter arterial chemoembolization therapy alone for inoperable primary liver cancer,without inflicting more treatment-related toxicities.