Efficacy of transcatheter arterial chemoembolization combined with radiotherapy for locally advanced hepatocellular carcinoma.

OBJECTIVE

To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) alone or in combination with radiotherapy or anlotinib for treating locally advanced hepatocellular carcinoma.

METHODS

A retrospective analysis was conducted on 72 patients with locally advanced hepatocellular carcinoma, divided into three groups: TACE alone (n = 20), TACE + anlotinib (TACE+AH, n = 34), and TACE + intensity-modulated radiotherapy (TACE+IMRT, n = 18). TACE was administered every 30 days. For TACE+AH, patients received 12 mg of anlotinib daily for 14 days per cycle. TACE+IMRT involved 400-500 cGy radiotherapy sessions three times weekly, with a total dose of 5000-6000 cGy.

RESULTS

No significant differences in Eastern Cooperative Oncology Group (ECOG) performance scores were observed among the groupspost-treatment. The TACE+IMRT group exhibited the highest objective response rate (ORR) (83.33%) and disease control rate (DCR) (88.89%). Progression-free survival (PFS) at 3, 6, and 12 months was also highest in the TACE+IMRT group, indicating superior outcome compared to the TACE+AH and TACE-alone groups. Independent predictors of PFS included the TACE+IMRT combination and Child-Pugh B grade.

CONCLUSION

TACE combined with radiotherapy is a safe and effective treatment for locally advanced hepatocellular carcinoma, significantly improving PFS and serving as a protective factor. While TACE combined with anlotinib showed moderate efficacy and manageable adverse events, its therapeutic effect was less pronounced than that of TACE+IMRT.