Scheduled Interval Trans-Catheter Arterial Chemoembolization Followed by Radiation Therapy in Patients with Unresectable Hepatocellular Carcinoma.
10.3346/jkms.2012.27.7.736
- Author:
Jeong Il YU
1
;
Hee Chul PARK
;
Do Hoon LIM
;
Cheol Jin KIM
;
Dongryul OH
;
Byung Chul YOO
;
Seung Woon PAIK
;
Kwang Cheol KHO
;
Joon Hyuk LEE
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hee.ro.park@samsung.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Carcinoma, Hepatocellular;
Radiationtherapy;
Trans-Catheter Arterial Chemoembolization;
Combination Treatment
- MeSH:
Adult;
Carcinoma, Hepatocellular/mortality/radiotherapy/*therapy;
Combined Modality Therapy;
*Embolization, Therapeutic;
Female;
Humans;
Kaplan-Meier Estimate;
Liver Neoplasms/mortality/radiotherapy/*therapy;
Male;
Middle Aged;
Prognosis;
Severity of Illness Index
- From:Journal of Korean Medical Science
2012;27(7):736-743
- CountryRepublic of Korea
- Language:English
-
Abstract:
Combination treatment of trans-catheter arterial chemoembolization (TACE) and conformal radiation therapy (RT) reported promising results in patients with hepatocellular carcinoma (HCC), but, optimal interval was not determined. We hypothesized that a two-week interval between TACE and RT would be optimal. Therefore, we designed this study to evaluate the safety and efficacy of scheduled interval TACE followed by RT. HCC patients who were not eligible for standard therapies were enrolled for scheduled interval TACE followed by RT (START). Patients received TACE on the first day of treatment, and then RT was delivered after 14 days. The entire course of treatment took between four and five weeks. In 81 patients (96.4%), START was completed in the planned treatment period. RT was delayed in the remaining three patients because of decreased liver function or poor performance status after TACE. Of the 81 patients, objective response was observed in 57 patients (70.4%). One unexpected death occurred after START due to hepatic failure. Other toxicities were manageable. The median survival was 14.7 months. There was a significant difference in overall survival according to the response to START (P < 0.001). In conclusion, START is safe and feasible.
