Clinical Outcomes of Transarterial Chemoembolization Combined with Hypofraction Radiation Therapy for Unresectable Large Hepatocellular Carcinoma
Objectives: Aims to evaluate the impact of transarterial chemoembolization (TACE) combined with γ-ray hypofraction radiation therapy (TACE-hRT) for unresectable large hepatocellular carcinoma (ULHCC) and compare the feasibility and efficacy of ULHCC treated by TACE-hRT in supine and prostrate position by turns (TACE-hRTt) with TACE-hRT alone in supine or prostrate position (TACE-hRTa).
Methods: The enrolled ULHCC patients (n=141) were treated with TACE-hRTa (n=59) and TACE-hRTt (n=82). The clinical outcomes were retrospectively analyzed and a comparison was made between two treatment modalities.
Results: The median progress free survival (PFS) and overall survival (OS) were 13.4 and 14.6 months for all enrolled patients, 7.9 months and 11.8 months for TACE-hRTa patients, 16.8 months and 18.3 months for TACE-hRTt patients, respectively. The OS rates of 1-, 3- and 5-year were 54.6%, 19.1%, 7.8% for all patients, 45.8%, 13.6%, 3.4% for TACE-hRTa patients and 61.1%, 23.2%, 11.2% for TACE-hRTt patients, respectively. No worse than grade 3 adverse effects (AEs) observed in all patients.
Conclusion: TACE-hRT is a feasible and efficient treatment modality for ULHCC. The modified modality of TACE-hRTt improves therapeutic responses and outcomes of ULHCC, compared to the TACE-hRTa. Higher marginal dose represents a predictor for the superior OS of patients with ULHCC.
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