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 three-dimensional conformal radio-therapy and thalidomide. Radiationwas delivered in 1.5Gy fractions twice daily for 5 days aweek, 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 radiotherapywith thalidomide seems to be effective in the treatment of advanced hepatocellular carcinoma. Key words: conformal radiotherapy – hepatocellular carcinoma – thalidomid