Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma
| Autor: | Françoise Mornex, Tammam Said, Marie Cuinet, Agnès Rode, Ciprian Enachescu, Fulgence Bathaix, Philippe Merle, Redouane Benlaredj |
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| Rok vydání: | 2014 |
| Předmět: |
Surgical resection
medicine.medical_specialty Hepatocellular carcinoma business.industry Radiofrequency ablation medicine.medical_treatment lcsh:R Conformal Radiotherapy lcsh:Medicine Conformal radiotherapy Liver transplantation medicine.disease digestive system diseases Surgery law.invention law medicine Overall survival Chemoembolization Radiology business Complete response |
| Zdroj: | International Journal of Cancer Therapy and Oncology, Vol 2, Iss 4 (2014) |
| ISSN: | 2330-4049 |
| DOI: | 10.14319/ijcto.0204.10 |
| Popis: | Purpose: A proportion of patients with uninodular hepatocellular carcinoma (HCC) cannot benefit from potential curative therapies such as liver transplantation, surgical resection or radiofrequency ablation. Thus, they are prone to receive transarterial chemoembolization (TACE) that is a palliative option with low probability of both complete response and prolonged local control. Herein, we assessed the combination of TACE and 3D-high dose conformal radiotherapy (3D-HDCRT) for efficacy and safety in HCC. Methods: We retrospectively analyzed the outcome of 35 consecutive patients with uninodular HCC ≤ 100 mm, treated by one course of TACE combined to 3D-HDCRT. The follow-up consisted on clinics, biology, hepatic CT-scan or MRI at month-1 and -3, and thereafter every 3 months. Results: Complete response was obtained in 80% of patients following mRECIST criteria (95% in HCC ≤ 50 mm, and 60% in HCC > 50 mm) with uncommon local recurrence (11%), overall survival rates of 79%, 59% and 44% at respectively 1, 2 and 3 years (median, 37.3 months), and 11.4% grade-3/4 toxicities. Pre-therapeutic α-fetoprotein level ≥ 200 ng/mL was found as a strong predictor of poorer outcome. Conclusion: We showed that TACE combined to 3D-HDCRT can be highly efficient to reach local control and interesting overall survival rates for uninodular HCC, with limited severe toxicities for Child-Pugh A patients. Subsequent prospective controlled trials are warranted for comparison with therapeutic standards. |
| Databáze: | OpenAIRE |
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