Chinese Hepatolgy ›› 2023, Vol. 28 ›› Issue (9): 1079-1083.

• Liver Cancer • Previous Articles     Next Articles

Evaluation of the therapeutic effect of transcatheter hepatic artery chemoembolization combined with large segment three-dimensional conformal radiotherapy on unresectable primary liver cancer

LI Ming1, JIANG Zhu-chun1, SHI Yong-gang2, DONG Shi-liang3, HE Zi-huai4, PAN Mei-fang1   

  1. 1. First Ward, Oncology Department, Hezhou Municipal People's Hospital, Henan 542800, China;
    2. Third Ward of Radiotherapy Department, the First Affiliated Hospital of Zhengzhou University, Henan 450052, China;
    3. Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China;
    4. Radiotherapy Technology Group, Hezhou Municipal People's Hospital, Henan 542800, China
  • Received:2023-06-05 Online:2023-09-30 Published:2023-10-24
  • Contact: JIANG Zhu-chun, Email:jiangzhuchun@163.com

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Abstract: Objective To explore the clinical efficacy of transcatheter hepatic arterial chemoembolization (TACE) combined with large segment three-dimensional conformal radiotherapy in the treatment of unresectable primary liver cancer.Methods 62 patients with unresectable primary liver cancer were retrospectively selected and divided into two groups according to different treatment methods: 30 patients received TACE treatment (intervention group), and 32 patients received TACE combined with large segment three-dimensional conformal radiotherapy for treatment (combined group). The short-term efficacy, mid-term and long-term efficacy, adverse reactions, and changes in serum chemokine 9 (CXCL9) and heat shock protein 90 (HSP90) levels before and after treatment were compared between the two groups. Results The total effective rate of the combination group was similar to that of the intervention group (84.38% vs 76.67%, P>0.05). Compared with before treatment, the serum levels of CXCL9, HSP90, and β-catenin were significantly reduced in both groups after treatment. The serum levels of CXCL9, HSP90, and β-catenin in the combination group after treatment were (658.82±27.96) pg/mL, (0.04±0.01) ng/mL, and (264.52±51.46) pg/L, respectively, which were significantly lower than (760.82±30.64) pg/mL, (0.05±0.02) ng/mL and (390.54±47.28) pg/L in the intervention group, all P<0.05. There was no statistically significant difference in the total incidence of adverse reactions between the combination group and the intervention group (31.25% vs 23.33%[2], P>0.05). The local control rate and progression free survival rate of the combined group at 6 months after treatment respectively were 81.25% and 78.13%, which were significantly higher than the 60.00% and 60.00% of the intervention group (P<0.05). The overall survival rate of the combined group at 12, 24, and 36 months of treatment was higher than that of the intervention group (84.38% vs 76.67%, 65.63% vs 46.67%, 50.00% vs 33.33%), the local control rate was higher than that of the intervention group (59.38% vs 40.00%, 50.00% vs 33.33%, 37.50% vs 23.33%), and the progression free survival rate was also higher than that of the intervention group (56.25% vs 33.33%, 46.88% vs 30.00%, 34.38% vs 16.67%), all P<0.05. Conclusion TACE combined with large segment three-dimensional conformal radiotherapy for unresectable primary liver cancer can effectively improve the local control rate of liver cancer, improve the mid-term and long-term efficacy of patients, and have good tolerance and high safety. Its mechanism of action may be related to downregulating serum CXCL9 and HSP90 levels, and inhibiting the Wnt signaling pathway.

Key words: Transcatheter hepatic arterial chemoembolization, Three-dimensional conformal radiotherapy, Primary liver cancer, Heat shock protein 90