title: The comparison of outcomes between hypofractionated and conventional 3D-CRT regimens used in combination with TACE as first-line treatment of advanced hepatocellular carcinoma.
abstract: Treatment of primary hepatocellular carcinoma (HCC) with transcatheter hepatic arterial chemoembolization (TACE) and three-dimensional conformal radiotherapy (3D-CRT) achieves good short-term but poor long-term survival. We retrospectively assessed whether outcomes differ between hypofractionated and conventional 3D-CRT regimens. Patients were treated in our institution between June 2005 and October 2009. All patients received two cycles of TACE followed by either hypofractionated 3D-CRT (6-8 Gy fractions for 3-4 weeks to 48-64 Gy) or conventional 3D-CRT (2 Gy fractions for 6-7 weeks to 60-70 Gy) 4 weeks later. We assessed data from 110 patients (55 in each 3D-CRT group). Overall response rates were similar in the two groups. Acute adverse event rates were not significantly higher in the hypofractionated 3D-CRT group than in the conventional 3D-CRT group; two patients and one patient, respectively, died of late radiation-induced liver failure. Overall survival at 1 year was 83.6 % in the hypofractionated 3D-CRT group versus 68.8 % in the conventional 3D-CRT group (P = 0.019), and at 3 years, it was 31.7 versus 13.9 % (P = 0.004). Median survival was 27.97 versus 16.13 months (P = 0.002). Hypofractionated 3D-CRT seemed to provide better overall survival than conventional 3D-CRT regimens combined with TACE as a first-line treatment for advanced HCC.
authors.affiliation: Department of Oncology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong Province, China.
authors.forename: Chuanxi
authors.initials: C
authors.lastname: Wang
authors.forename: Suping
authors.initials: S
authors.lastname: Li
authors.forename: Aimin
authors.initials: A
authors.lastname: Sun
authors.forename: Longhua
authors.initials: L
authors.lastname: Chen
authors.forename: Rongxiang
authors.initials: R
authors.lastname: Liang
authors.forename: Guanzhen
authors.initials: G
authors.lastname: Li
authors.forename: Junqing
authors.initials: J
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D020266:Radiotherapy, Conformal; D016019:Survival Analysis; D016896:Treatment Outcome