© 2006 Foundation for Promotion of Cancer Research
Results of Three-Dimensional Conformal Radiotherapy and Thalidomide for Advanced Hepatocellular Carcinoma
Departments of 1 Radiation Oncology, 2 Radiology, 3 Gastroenterology and 4 General Surgery, Cheng-Ching General Hospital, Taichung, 5 Department of Pharmacy, Buddhist Tzu-Chi General Hospital, Hualien and 6 Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
For reprint and all correspondence: Po-Ming Wang, Department of Radiation Oncology, Cheng-Ching General Hospital, Taichung, Taiwan, No. 118, Sec. 3, Chung-Kang Rd, Taichung, 407, Taiwan. E-mail: b753500{at}yahoo.com.tw
Received September 1, 2005; accepted November 29, 2005
Purpose: To evaluate the effectiveness of three-dimensional conformal radiotherapy and thalidomide in the treatment of advanced hepatocellular carcinoma.
Methods: Between 1999 and 2003, 121 patients (mean age, 54.4 ± 12.4 years; range, 20–81 years) with advanced hepatocellular carcinoma received three-dimensional conformal radiotherapy and thalidomide. Radiation was delivered in 1.5 Gy fractions twice daily for 5 days a week, for a total dose of 45–75 Gy. Mean treatment volume was 429.52 ± 408.50 cm3 (range, 26.89–2284.82 cm3). Thalidomide was given concomitantly: 200 mg/day in 109 patients, 300 mg/day in 8 patients and 400 mg/day in 4 patients. Treatment responses, survival rates and factors affecting survival were analyzed.
Results: Treatment responses were observed in 61% of the patients. Liver cirrhosis (P = 0.001) and tumor size (P = 0.001) significantly affected the tumor responses. Overall survival at 6, 12 and 24 months was 84.8, 60.0 and 44.6%, respectively. On univariate analysis, liver cirrhosis (P = 0.003), Karnofsky performance status (P = 0.007), tumor size (P < 0.001), portal vein tumor thrombosis (P < 0.001) and alpha-fetoprotein level (P = 0.003) were shown to significantly affect survival. On multivariate analysis, only thrombosis (P = 0.039) and alpha-fetoprotein level (P = 0.006) were shown to be factors affecting survival.
Conclusions: Three-dimensional conformal radiotherapy with thalidomide seems to be effective in the treatment of advanced hepatocellular carcinoma.
Key Words: conformal radiotherapy • hepatocellular carcinoma • thalidomide
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