Results of Three-Dimensional Conformal Radiotherapy and Thalidomide for Advanced Hepatocellular Carcinoma

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 thr...

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Published in:Japanese journal of clinical oncology 2006-02, Vol.36 (2), p.93-99
Main Authors: Hsu, Wei-Chung, Chan, Sue-Ching, Ting, Lai-Lei, Chung, Na-Na, Wang, Po-Ming, Ying, Kung-Shih, Shin, Jeng-Shiann, Chao, Che-Jen, Lin, Gau-De
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - radiotherapy
Combined Modality Therapy
conformal radiotherapy
Female
hepatocellular carcinoma
Humans
Imaging, Three-Dimensional
Liver Neoplasms - drug therapy
Liver Neoplasms - pathology
Liver Neoplasms - radiotherapy
Male
Middle Aged
Prognosis
Radiotherapy, Conformal
Survival Analysis
Survival Rate
thalidomide
Thalidomide - adverse effects
Thalidomide - therapeutic use
Treatment Outcome
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Summary: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.
ISSN:0368-2811
1465-3621
DOI:10.1093/jjco/hyi242