Table 3.
Clinical outcomes of TACE+RT for hepatocellular carcinoma
| Reference | Design | Patient number | RT dose | Response rate | Survival | |
|---|---|---|---|---|---|---|
| Prospective studies | ||||||
| Li B, et al. [40] (2003) | Phase II, TACE+RT | 45 | All stage III, KPS ≥70, CP A, B | 45 Gy25 fx -> boost 5.4 Gy/3 fx | CR6, PR 35, SD 4, PD 0 | 1-yr 69%, 2-yr 48%, 3-yr 23%, median 23.5 months |
| Oh D, et al. [41] (2010) | Phase II, TACE+RT | 40 | HCC which failed after 1-2 courses of TACE | Median 54 Gy in 3 Gy/fx | Objective response rate: 63% (CR 9, PR 18), 9 progressions within the irradiated field | 1-yr 72%, 2-yr 46% |
| Leng ZQ, et al. [42] (2000) | Phase III, TACE+RT vs. TACE | 36 vs. 39 | Stage II, III, IVA, KPS ≥65, CP A | 27.6–33.6 Gy to ‘volume including whole live area->11.4–32.4 Gy boost | 1-yr 75% vs. 61%, 2-yr 57% vs. 34% | |
| Zhao MH, et al. [43] (2006) | Phase III, TACE+RT vs. TACE | 49 vs. 47 | T1-2N0M0, KPS ≥70, CP A, PVT (-) | 45-55 Gy | TACE+RT: CR 17, PR 18, PD 5, TACE: CR 8, PR 11, PD 11 | 1-yr 82% vs. 55%, 2-yr 63% vs. 28% |
| Koo JE, et al. [44] (2010) | Phase II, TACE+RT (vs. historical control TACE alone) | 42 vs. 29 | All with IVCT, CP A, B | Median 45 Gy in 2.5-5 Gy/fx (determined by the extent of thrombosis) | Objective response rate: 43% vs. 14% | Median 12 vs. 5 months, 1-yr 48% vs. 17% |
| Choi C, et al. [45] (2014) | Phase II, TACE+RT | 31 | HCC which failed after 1-3 courses of TACE, CP A, B | Median 54 Gy in 1.8-2 Gy/fx | In-field CR 24%, PR 59% at 12 wks Overall CR 10%, PR 52% at 12 wks | 2-yr 61% |
| Retrospective studies | ||||||
| Cheng JC, et al. [46] (2000) | TACE+RT or RT alone | 16, 6 | Stage II-IV, CP A, B, median 10 cm | 46.9 ± 5.9 Gy in 1.8-2 Gy/fx | Only 3 local prgression (area treated with RT) | 1-yr 54%, 2-yr 41%, median 19.2 months |
| Guo WJ, et al. [47] (2003) | TACE+RT vs. TACE | 76 vs. 89 | Stage I-III, KPS ≥70, CP A, B | 1.8–2.0 Gy/fx* 15–28fx | Objective response rate: 47% vs. 28% | 1-yr 64% vs. 40% |
| Li Y, et al. [48] (2003) | TACE+RT vs. TACE | 41 vs. 41 | Size: 3.2-11.5 cm, CP A, B | PTV <216 cm3: 5–8 Gy/fx* 5–12fx, PTV > 216 cm3: 4 Gy/fx* 11-14 fx | TACE+RT: CR 4, PR 23 TACE: CR 1, PR 23 | 1-yr 73% vs. 55% |
| Zeng ZC, et al. [36] (2004) | TACE+RT vs. TACE | 54 vs. 203 | Size>10 cm: overall 31%, CP A, B | 2 Gy/fx* 18-30 fx | CR+PR: 76% vs. 31% | 1-yr 72% vs. 60%, 3-yr 24% vs. 11% |
| Chen WJ, et al. [49] (2014) | TACE+RT vs. TACE | 78 vs. 80 | Objective response rate: 72% vs. 54% | 1-yr 78% vs. 59%, 3-yr 26% vs .16% | ||
| Shim SJ, et al. [37] (2005) | TACE+RT vs. TACE | 38 vs. 35 | Stage III, IV, stage ≥5 cm, CP A, B | 1.8 Gy/fx* 17–33fx | TACE+RT: CR 0, PR 25 | 2-yr 37% vs. 14% (benefit twith large tumors) |
KPS, Karnofsky performance status; CP, child-pugh; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; HCC, hepatocellular carcinoma; PVT, portal vein thrombosis; IVCT, inferior vena cava thrombosis; TACE, transcatheter arterial chemoembolization; RT, radiotherapy; PTV, planning target volume.