TACE Combine With 3D-CRT Treat For HCC With PVTT And Multiple Factors Analysis Of Survival Prognosis

Backgrounds:Advanced liver cancer patients often occurs portal vein tumor thrombus.For HCC with PVTT patients,non-surgical treatment is currently the main method,including interventional therapy,radiotherapy,radiofrequency ablation,and so on.Transcatheter arterial chemoembolization(TACE)combined with radiotherapy is a more commonly used treatment method in recent years,But its clinical efficacy needs further research to confirm.Materials and Methods:78 HCC with PVTT patients who met the criteria and were admitted to Zhongshan Hospital Affiliated to Xiamen University from June 2015 to June 2019 were divided into TACE group and TACE+3D-CRT group according to different treatments.This study retrospectively analyzed the survival time,tumor progression-free time,and treatment-related serious complications of the two groups of patients.Kaplan-Meier and COX regression models were used to analyze the independent risk factors affecting the survival prognosis of patients.Results:In this study,the median overall survival time was 10 months,and the estimated average survival time was 14.2 months.The TACE group’s 3-month,6-month,1-year,and 2-year survival rates respectively were 76.36%,54.55%,35.77%,and 7.82%.The median survival time was 8 months,and the estimated average survival time was 10.6 months.The median time to progression was 5 months,and the average time to progression was estimated to be 8.6 months.Patients in the TACE+3D-CRT group had 100%,73.04%,59.32%,and 21.74%in 3-month,6-month,1-year and 2-year survival rates respectively.The median survival time was 13 months and the estimated average survival time was 21.9 months,the median time to progression-free tumor was 10 months,and the average time to progression-free was estimated at 20.0.The survival time and tumor progression-free time in the TACE+3D-CRT group were significantly longer than those in the TACE group(P=0.006,P=0.008).COX analysis showed that:age,number of interventions,treatment methods,alpha-fetoprotein,liver function classification,distant metastasis,multiple,PVTT classification were related to patient prognosis.There were no significant differences in treatment-related serious complications between the two groups in this study.Conclusion:For HCC with PVTT patients,TACE combined with 3D-CRT has a better prognosis for patients treated with TACE,and TACE combined with 3D-CRT is safe for liver cancer with portal vein thrombosis.