Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

Abstract

Original ArticleAbstract 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 mRE-CIST 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.

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided radiofrequency ablation in the treatment of solitary large hepatocellular carcinoma

“…For unresectable large HCCs, especially solitary large HCCs, transcatheter arterial chemoembolization (TACE) has become the primary treatments [ 4 – 6 ]. Of note, any single treatment has its own limitations and, thus, its efficacy is usually dissatisfactory.…”

β-Elemene Inhibits Cell Proliferation by Regulating the Expression and Activity of Topoisomerases I and IIαin Human Hepatocarcinoma HepG-2 Cells

“…Until now, no survival benefit has been demonstrated with any chemotherapy (systemic treatment) for patients with hepatocellular carcinoma (HCC) [ 1 , 2 ]. Although sorafenib is the first drug to modestly improve the survival of patients with HCC, more appropriate use of this drug is recommended because of serious adverse events and deaths that have occurred in Japan [ 3 ]. An efficient drug against hepatocarcinoma for the therapy of HCC is anxiously anticipated.…”