Clinical Observation On Combined Therapy Of Transcatheter Arterial Chemoembolization(TACE) And Three-dimensional Conformal Radiotherapy(3D-CRT) For Treatment Of Primary Hepatocellular Carcinoma(PHC)

[Objective] To evaluate the clinical efficacy and adverse reaction of the combined therapy of transcatheter arterial chemoembolization (TACE) and three-dimensional conformal radiotherapy (3D-CRT) for primary’hepatocellular carcinoma (PHC).[Methods] Sixty-four patients with medically unresectable and technically inoperable PHC patients, definitely diagnosed by the standard with iconography and AFP, were divided into two groups:the therapy group (thirty-five patients who received TACE+3D-CRT treatment) and the controlled group (twenty-nine cases with only TACE). TACE was performed first for both groups,1-3times of TACE was managed by iodinated oil5～20ml+MMC4～10mg+CBP25～100mg+E-ADM10～30mg through Seldinger’s method. After2weeks of interval, patients in the therapy group received3D-CRT with linear accelerator15MV-X ray. The total radiation dosage was50-62GY in conventional fraction (2GY per fraction, five consecutive times per week). The short-term effects were evaluated in accordance with WHO solid tumor evaluation standard and long-term effects by three-year survival rate. Observe the short-term and long-term effects of the combined therapy as well as adverse reactions with reference to the corresponding standards.[Results]①The short-term effect:the response rate (RR) in the therapy group and the controlled group were77.14%and51.72%,respectively.The difference between the two groups was statistically (p<0.05).②Survival analysis:The overall survival rates at1-,2-and3-year,median survival time in the therapy were79.7%,52.3%,23.0%,25months, respectively, and the controlled group59.4%,20.3%,6.8%,15months, respectively. The data above had statistically significance (p<0.05).③Adverse reaction:there were similar in both groups and the difference between them was no sufficient(p>0.05).No server adverse reactions were occurred and could be controlled after symptomatic and supportive treatment.[Conclusions] The newly combined modality of TACE and3D-CRT in our study was a satisfactory treatment in effectively controlling the tumors and improving patients survival, with little tolerable side-effects.