Radiothérapie et chimiothérapie intra-artérielle des carcinomes hépatocellulaires localement évolués. Analyse des facteurs pronostiques

Summary stic factors in the treatment of local advanced hepatocellular carcinoma with radiotherapy, transcatheter arterial embolization and arterial infusion. e eatment effects of radiotherapy and combination modality therapy for the local advanced hepatocellular carcinoma (HCC) were retrospectively reviewed. al and methods hundred and fifty-six patients of HCC (187 recurrent cases after surgical resection) were treated by 1) radiotherapy only; 2) Bi-therapeutic method: hepatic artery ligation (HAL) and/or hepatic artery embolization (HAE) plus radiotherapy ; and 3) tri-therapeutic method (bi-therpeutic method plus hepatic artery infusion) from 1975 to 1996. Kaplan-Meier method has been used to evaluate the survival rates. s were no significant differences among these three treatment groups in the symptom relief rate, but the mean relief time period was much shorter in radiotherapy alone group (2.5 vs 44 months, P<0.05). A lower tumor response rate was found in the radiotherapy alone group (P<0.05), although that was similar for both primary or recurrent tumors (P> 0.05). There were evident differences in five-year survivals among these three treatment groups: 0% for radiotherapy alone, 22.8% for bi-therapeutic method and 38.8% for tri-therapeutic method (P<0.01). The prognosis was influenced by Okuda classification. sion sectable local advanced HCC can be treated by the combination modality therapy, including radiotherapy, with a quite high cure rate. Radiotherapy alone can relief the symptoms. © 2000 ةditions scientifiques et médicales Elsevier SAS