SPECT-Based Radiation Therapy and Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma Sized 14 cm or Greater

Shintaro Shirai, Morio Sato, Yasutaka Noda, Kazushi Kishi, Akira Ikoma, Hiroki Sanda, Tetsuo Sonomura, Hiroki Minamiguchi, Motoki Nakai, Nobuyuki Kawai


Purpose: To evaluate the feasibility of single photon emission computed tomography-based three-dimensional conformal radiotherapy (SPECT-B3DCRT) combined with transcatheter arterial chemoembolization (TACE) for large unresectable hepatocellular carcinoma. Methods: Twelve patients with unresectable hepatocellular carcinoma (HCC) sized 14 cm or greater underwent SPECT using Tc-99m-galactosyl human serum albumin before 3DCRT to explore the optimal irradiation beam angle to cover the clinical target volume (CTV) to a total dose of 45 Gy/18 fractions while preserving functional liver volume (FLV). The TACE was scheduled within two months after completion of 3DCRT. Results: Local control rate was 78.6% at 2 years. Median over-all survival was 10.1 months and the survival rate at 1 and 2 years was 41.7 and 33.3%, respectively. Conclusions: SPECT-B3DCRT combined with TACE appears to be tolerable and effective for patients with HCC sized 14 cm or greater in terms of local control and survival.

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DOI: https://doi.org/10.5539/cco.v1n1p65


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