title: Results of three-dimensional conformal radiotherapy and thalidomide for advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the effectiveness of three-dimensional conformal radiotherapy and thalidomide in the treatment of advanced hepatocellular carcinoma.
  
  
  METHODS
  Between 1999 and 2003, 121 patients (mean age, 54.4 +/- 12.4 years; range, 20-81 years) with advanced hepatocellular carcinoma received three-dimensional conformal radiotherapy and thalidomide. Radiation was delivered in 1.5 Gy fractions twice daily for 5 days a week, for a total dose of 45-75 Gy. Mean treatment volume was 429.52 +/- 408.50 cm(3) (range, 26.89-2284.82 cm(3)). Thalidomide was given concomitantly: 200 mg/day in 109 patients, 300 mg/day in 8 patients and 400 mg/day in 4 patients. Treatment responses, survival rates and factors affecting survival were analyzed.
  
  
  RESULTS
  Treatment responses were observed in 61% of the patients. Liver cirrhosis (P = 0.001) and tumor size (P = 0.001) significantly affected the tumor responses. Overall survival at 6, 12 and 24 months was 84.8, 60.0 and 44.6%, respectively. On univariate analysis, liver cirrhosis (P = 0.003), Karnofsky performance status (P = 0.007), tumor size (P < 0.001), portal vein tumor thrombosis (P < 0.001) and alpha-fetoprotein level (P = 0.003) were shown to significantly affect survival. On multivariate analysis, only thrombosis (P = 0.039) and alpha-fetoprotein level (P = 0.006) were shown to be factors affecting survival.
  
  
  CONCLUSIONS
  Three-dimensional conformal radiotherapy with thalidomide seems to be effective in the treatment of advanced hepatocellular carcinoma.
authors.affiliation: Department of Radiation Oncology, Cheng-Ching General Hospital, Taichung, Taiwan.
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Hsu
authors.forename: Sue-Ching
authors.initials: SC
authors.lastname: Chan
authors.forename: Lai-Lei
authors.initials: LL
authors.lastname: Ting
authors.forename: Na-Na
authors.initials: NN
authors.lastname: Chung
authors.forename: Po-Ming
authors.initials: PM
authors.lastname: Wang
authors.forename: Kung-Shih
authors.initials: KS
authors.lastname: Ying
authors.forename: Jeng-Shiann
authors.initials: JS
authors.lastname: Shin
authors.forename: Che-Jen
authors.initials: CJ
authors.lastname: Chao
authors.forename: Gau-De
authors.initials: GD
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020266:Radiotherapy, Conformal; D016019:Survival Analysis; D015996:Survival Rate; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide