| Objective:To evaluate the efficacy and side effect of combined therapy of accurate radiotherapy and transcatheter arterial chemo-embolization (TACE) for advanced hepatocellular carcinoma (HCC).Methods:36cases of unresectable HCC patients who seeked medical advice in the affiliated hospital of Qingdao University were randomly divided into A group with TACE combined with precise radiotherapy and B group with TACE therapy. Sequence of treatments for A group of13patients was that TACE was performed1to2times firstly with the interval was2-4weeks, followed by accurate radiotherapy which include three dimensional conformal radiation therapy (3DCRT), intensity modulated radiation therapy (IMRT) and imaging guided radiation therapy (IGRT) after the liver function were normal with an interval of2to4weeks between two treatment methods. The radiation total tumor dose was36to52Gy by conventional fractionation (1.8to2.3Gy per fraction, five fractions a week). TACE was administered by epirubicin (EPI)30mg/m2,cis-platinum (DDP)30to40mg/m2, arsenic trioxide (As2O3)8mg/m2and the dosage was adjusted according to the physical condition and tumor size, and embolismed the tumor feeding artery with iodized oil and gelfoam embolization. The treatments for B group of23patients was that single TACE was performed1-4times with an interval of2to4weeks and with the same medication compared with A group.Results:The efficiency of group A was significantly higher than group B (P=0.039) with the efficiency of group A, B were84.6%and47.8%respectively. The overall survival rates at1year of group A was higher than group B (P=0.041) with the overall survival rates at1year of group A and group B were76.9%and39.1%respectively. But the toxicity between group A and B had no significant difference (P>0.05).Conclusions: The combined modality of accurate radiotherapy and TACE can improve the efficacy of HCC, and can prolong the patients’ overall survival rates, and were tolerable for the majority of HCC patients. |
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