title: [Efficacy of transarterial chemolipiodolization with or without 3-dimensional conformal radiotherapy for huge HCC with portal vein tumor thrombosis].
abstract: OBJECTIVE
  The treatment efficacy for advanced hepatocellular carcinoma is poor. This study examined the efficacy and toxicity of 3-dimensional conformal radiotherapy (3D-CRT) in combination with transarterial chemolipiodolization (TACL) for a huge hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).
  
  
  METHODS
  From March 2001 to November 2004, 49 patients with advanced HCC with PVTT (size>8 cm, modified UICC stage IVa) were enrolled in this retrospective study. Twenty two patients underwent more than 2 cycles of TACL (adriamycin 50 mg/m(2), cisplatin 60 mg/m(2), 5-fluorouracil 200 mg/m(2) every 4-6 weeks) without 3D-CRT, while 27 patients underwent consecutive TACL with 3D-CRT (40-45 Gy for 4-5 weeks) that was started one week after the 1st TACL. The response was assessed by a computed tomography (CT) and the serum alpha-fetoprotein (AFP) level at 1-2 month intervals.
  
  
  RESULTS
  The objective response rates in the TACL group and TACL with 3D-CRT group were 18% and 48% at 3 months (P=0.051), and 10.5% and 42% at 6 months (P=0.024) respectively. The median survival time was 13 months and 13.5 months in TACL and TACL with 3D-CRT groups, respectively (P=0.502). The treatment response was better in the TACL with 3D-CRT group but there was no significant difference in survival between the two groups. Most toxicities in the two groups were mild, not exceeding grade 1 according to the WHO criteria.
  
  
  CONCLUSIONS
  For patients with a huge HCC with PVTT, TACL with 3D-CRT achieved some meaningful clinical benefit. Prospective controlled trials will be needed to confirm the real benefit of TACL combined with 3D-CRT.
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Chan Ran
authors: CR
authors: You
authors: Jeong Won
authors: JW
authors: Jang
authors: Seok Hui
authors: SH
authors: Kang
authors: Si Hyun
authors: SH
authors: Bae
authors: Jong Young
authors: JY
authors: Choi
authors: Seung Kew
authors: SK
authors: Yoon
authors: Ihl Bhong
authors: IB
authors: Choi
authors: Dong Hoon
authors: DH
authors: Lee
authors: Ho Jong
authors: HJ
authors: Chun
authors: Byung Gil
authors: BG
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000532:radiotherapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012720:Severity of Illness Index; D016019:Survival Analysis; D020246:Venous Thrombosis / Q000209:etiology / Q000532:radiotherapy / Q000628:therapy*