Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma

Jinsil Seong, Ki Chang Keum, KwangHyub Han, Do Yun Lee, Jong Tae Lee, Chae Yoon Chon, Young Myoung Moon, Chang-Ok Suh, Gwi Eon Kim

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Purpose: The best prognosis in hepatocellular carcinoma (HCC) can be achieved with surgical resection; however, the number of resected cases are limited due to advanced lesions or associated liver disease. The purpose of this study was to investigate the efficacy and toxicity of a prospective trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) in unresectable HCC. Methods and Materials: Patients with histologically proven unresectable HCC due to either advanced lesions or associated cirrhosis were eligible. From March 1992 to August 1994, 30 patients were entered into this study. TACE was performed with Lipiodol (5 ml) and doxorubicin (Adriamycin(TM); 50 mg), followed by gelatin sponge particle (Gelfoam(TM)) embolization. Local RT was started within 7-10 days following TACE. Mean tumor dose was 44.0 ± 9.3 Gy in daily 1.8 Gy fractions. Response was assessed by computerized tomography (CT) scan 4-6 weeks following completion of the treatment and then at 1-3-month intervals. Survival was calculated from the start of TACE using the Kaplan-Meier method. Results: An objective response was observed in 19 patients, giving a response rate of 63.3%. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone. Survival rates at 1, 2, and 3 years were 67%, 33.3%, and 22.2%, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Toxicity included transient elevation of liver function tests in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment- related death. Conclusion: Combined TACE and local RT is feasible and tolerable. It gives a 63.3% response rate with median survival of 17 months. We feel that this regimen would be a new promising modality in unresectable HCC. Further study is required to compare the therapeutic efficacy of this regimen to TACE alone.

Original languageEnglish
Pages (from-to)393-397
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume43
Issue number2
DOIs
Publication statusPublished - 1999 Jan 15

Fingerprint

Hepatocellular Carcinoma
radiation therapy
Radiotherapy
cancer
liver
toxicity
Doxorubicin
lungs
lesions
Survival
vomiting
nausea
fever
Absorbable Gelatin Sponge
Ethiodized Oil
Lung
prognosis
Liver Function Tests
gelatins
Porifera

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Seong, Jinsil ; Keum, Ki Chang ; Han, KwangHyub ; Lee, Do Yun ; Lee, Jong Tae ; Chon, Chae Yoon ; Moon, Young Myoung ; Suh, Chang-Ok ; Kim, Gwi Eon. / Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma. In: International Journal of Radiation Oncology Biology Physics. 1999 ; Vol. 43, No. 2. pp. 393-397.
@article{23f601749dc1468aa49b6687aff961d1,
title = "Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma",
abstract = "Purpose: The best prognosis in hepatocellular carcinoma (HCC) can be achieved with surgical resection; however, the number of resected cases are limited due to advanced lesions or associated liver disease. The purpose of this study was to investigate the efficacy and toxicity of a prospective trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) in unresectable HCC. Methods and Materials: Patients with histologically proven unresectable HCC due to either advanced lesions or associated cirrhosis were eligible. From March 1992 to August 1994, 30 patients were entered into this study. TACE was performed with Lipiodol (5 ml) and doxorubicin (Adriamycin(TM); 50 mg), followed by gelatin sponge particle (Gelfoam(TM)) embolization. Local RT was started within 7-10 days following TACE. Mean tumor dose was 44.0 ± 9.3 Gy in daily 1.8 Gy fractions. Response was assessed by computerized tomography (CT) scan 4-6 weeks following completion of the treatment and then at 1-3-month intervals. Survival was calculated from the start of TACE using the Kaplan-Meier method. Results: An objective response was observed in 19 patients, giving a response rate of 63.3{\%}. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone. Survival rates at 1, 2, and 3 years were 67{\%}, 33.3{\%}, and 22.2{\%}, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Toxicity included transient elevation of liver function tests in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment- related death. Conclusion: Combined TACE and local RT is feasible and tolerable. It gives a 63.3{\%} response rate with median survival of 17 months. We feel that this regimen would be a new promising modality in unresectable HCC. Further study is required to compare the therapeutic efficacy of this regimen to TACE alone.",
author = "Jinsil Seong and Keum, {Ki Chang} and KwangHyub Han and Lee, {Do Yun} and Lee, {Jong Tae} and Chon, {Chae Yoon} and Moon, {Young Myoung} and Chang-Ok Suh and Kim, {Gwi Eon}",
year = "1999",
month = "1",
day = "15",
doi = "10.1016/S0360-3016(98)00415-5",
language = "English",
volume = "43",
pages = "393--397",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "2",

}

Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma. / Seong, Jinsil; Keum, Ki Chang; Han, KwangHyub; Lee, Do Yun; Lee, Jong Tae; Chon, Chae Yoon; Moon, Young Myoung; Suh, Chang-Ok; Kim, Gwi Eon.

In: International Journal of Radiation Oncology Biology Physics, Vol. 43, No. 2, 15.01.1999, p. 393-397.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma

AU - Seong, Jinsil

AU - Keum, Ki Chang

AU - Han, KwangHyub

AU - Lee, Do Yun

AU - Lee, Jong Tae

AU - Chon, Chae Yoon

AU - Moon, Young Myoung

AU - Suh, Chang-Ok

AU - Kim, Gwi Eon

PY - 1999/1/15

Y1 - 1999/1/15

N2 - Purpose: The best prognosis in hepatocellular carcinoma (HCC) can be achieved with surgical resection; however, the number of resected cases are limited due to advanced lesions or associated liver disease. The purpose of this study was to investigate the efficacy and toxicity of a prospective trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) in unresectable HCC. Methods and Materials: Patients with histologically proven unresectable HCC due to either advanced lesions or associated cirrhosis were eligible. From March 1992 to August 1994, 30 patients were entered into this study. TACE was performed with Lipiodol (5 ml) and doxorubicin (Adriamycin(TM); 50 mg), followed by gelatin sponge particle (Gelfoam(TM)) embolization. Local RT was started within 7-10 days following TACE. Mean tumor dose was 44.0 ± 9.3 Gy in daily 1.8 Gy fractions. Response was assessed by computerized tomography (CT) scan 4-6 weeks following completion of the treatment and then at 1-3-month intervals. Survival was calculated from the start of TACE using the Kaplan-Meier method. Results: An objective response was observed in 19 patients, giving a response rate of 63.3%. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone. Survival rates at 1, 2, and 3 years were 67%, 33.3%, and 22.2%, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Toxicity included transient elevation of liver function tests in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment- related death. Conclusion: Combined TACE and local RT is feasible and tolerable. It gives a 63.3% response rate with median survival of 17 months. We feel that this regimen would be a new promising modality in unresectable HCC. Further study is required to compare the therapeutic efficacy of this regimen to TACE alone.

AB - Purpose: The best prognosis in hepatocellular carcinoma (HCC) can be achieved with surgical resection; however, the number of resected cases are limited due to advanced lesions or associated liver disease. The purpose of this study was to investigate the efficacy and toxicity of a prospective trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) in unresectable HCC. Methods and Materials: Patients with histologically proven unresectable HCC due to either advanced lesions or associated cirrhosis were eligible. From March 1992 to August 1994, 30 patients were entered into this study. TACE was performed with Lipiodol (5 ml) and doxorubicin (Adriamycin(TM); 50 mg), followed by gelatin sponge particle (Gelfoam(TM)) embolization. Local RT was started within 7-10 days following TACE. Mean tumor dose was 44.0 ± 9.3 Gy in daily 1.8 Gy fractions. Response was assessed by computerized tomography (CT) scan 4-6 weeks following completion of the treatment and then at 1-3-month intervals. Survival was calculated from the start of TACE using the Kaplan-Meier method. Results: An objective response was observed in 19 patients, giving a response rate of 63.3%. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone. Survival rates at 1, 2, and 3 years were 67%, 33.3%, and 22.2%, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Toxicity included transient elevation of liver function tests in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment- related death. Conclusion: Combined TACE and local RT is feasible and tolerable. It gives a 63.3% response rate with median survival of 17 months. We feel that this regimen would be a new promising modality in unresectable HCC. Further study is required to compare the therapeutic efficacy of this regimen to TACE alone.

UR - http://www.scopus.com/inward/record.url?scp=0033556688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033556688&partnerID=8YFLogxK

U2 - 10.1016/S0360-3016(98)00415-5

DO - 10.1016/S0360-3016(98)00415-5

M3 - Article

VL - 43

SP - 393

EP - 397

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 2

ER -