Three-dimensional Conformal Radiotherapy Combined With Transcatheter Arterial Interventional Chemotherapy In The Treatment Of Primary Liver Cancer

Objective:To evaluate the therapeutic effect of 3-dimentional conformal radiotherapy(3DCRT) combined with transcather arterial chemoembolization(TACE) and investigate the factors affecting prognosis in patients with unresectable primary hepatic carcinoma.Methods:From January 2004 to June 2005,sixty patients with unresectable PLC were initiall treated with TACE and then sequentially 30 patients with 3DCRT. Accourding to Okuda 1 staging system.There were 22 T1 patints alone respectively,8 T2 patients respectively with none of them having lymph node metastasis.The mean value of gross tumor volume(GTV) was(487±98) cm~3,23 patients with 3DCRT combinded with TACE and 21 patients with TACE had Child-pugh Grade A liver cirrhosis respectively,7 patients with 3DCRT combinded with TACE and 9 patients with TACE had child-pugh grade B Liver cirrhosis.30 patients with 3DCRT received a total dose of 42～76Gy/2Gy per fraction/5 fractions per week with prescription dose at 90%isodose line.The therapeutic effects and overall survival rate of the patients were assessed as endpoints with Cox proportional hazard model used to investgate prognostic factors.Results:The total effective rate of treatment of late stage PLC with three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization is significantly higher than the group only received transcatheter arterial chemoembolization(P＜0.05),(CR+PR) response rate were 70.0%and 33.3% respectively.The overall 1-,2-,3-year survival rate increase significantly(P＜0.05) The overall 1-,2-and 3-year survival rate after treatment with 3DCRT and TACE was 73.3%,40.0%and 23.3%respectively.Multivariate analysis revealed significant prognostic factors as follows:UICC/AJCC T stage,Child-pugh grade of liver cirrhosis, radiotherapy dose and gross tumor volume,This method has no severe toxicity and side-effect.Conclusion:3DCRT can locate and plan exactly.Combinaton of three-dimensional conformal radiotherapy and transcatheter arterial chemoembolization is an effective,safe and favored approach for unresettable liver carcinoma.This method can increase the survival period of patients and improve their quality of life.