Therapeutic Effect Of Transarterial Chemoembolization Combined With γ-knife Or Purely Transarterial Chemoembolization Or Purely γ-knife For Patients With Primary Hepatocellur Carcinom:Comparative Study

ObjectiveTo analyze the reponse and to lerance of patients with primary hepatocellular carcinoma treated by transcatheter arerial chemoem-bolization(TACE),γ-ray three-dimensional fractionated stereotactic conformal radiotherapy(FSCR),transcatheter arerial chemoem-bolization(TACE)combined withy-ray three-dimensional fractionated stereotactic conformal radiotherapy(FSCR),in order to cooperation exploring the involvement of a set of standardized treatment modalities, the elevation of three therapeutic effects.Subjects and methodsThis retrospective cohort study analyzed121patients with primary hepatocellular carcinoma from March2008to January2010in Second Xiangya Hospital of Central South University and Armed Police General Hospital in Hunan Province. According to treatment,divided into three groups:46patients were treated by TACE,36patients were treated by γ-knife,39were treated by y-knife and TACE. For TACE,80-100mg Nedaplatin or Lobaplatin,20-40mg Epirubicin,1000-1500mg5fluorouracil,10-20mg mgmitomycin C were perfused into the hepatic arteries,5-40ml iodized oil were given to emobolized the hepatic arteries, and each patient was treated with1-3sessions. For y-knife,50%-70%isodose included PTV,dosage of400-500cGy/frations, 5time/each week, a total of8-14times was used,total dose in tumor marging was50-70Gy. y-knife was performed after1-3times TACE was given.ResultsCompared with basic informations on patients of three groups, the difference was not statistically significant (P>0.05). In TACE alone group, y-knife alone group, TACE combined withy-knife group,the total effective rate after three months was (CR+PR)41.3%(19/46)33.3%(19/36).64.1%(25/39), respectively. The difference in three groups was statistically significant (P<005),and overall survival rates after6,12,18,24months were50%、34.8%、28.3%、21.7%;36.1%、30.6%、16.7%.11.1%;84.6%、71.8%、61.5%、30.8%;respectively. The difference of overall survival rates after6,12,18months in three groups was statistically significant (P<005), but the difference of overall survival rates after24months in three groups was not statistically significant (P>005).In TACE alone group, y-knife alone group, TACE combined withy-knife group,mean survival time was1,3,20months, the difference of survival time in three groups was statistically significant (P<005). The difference of Leukopenia in three groups was statistically significant (P<005), and the difference of thrombocytopenia, anemia, nausea,vomiting,Liver function lesion in three groups was not statistically significant (P>005). ConclusionTranscatheter arerial chemoembolization(TACE) combined withy-knife was a safe and effective trentment for primary hepatocellular carcinoma. In TACE combined withy-knife group, the number and staging of tumor, child-pugh classification were the key factors in clinical prognosis.