[Clinical control of different sequential order of three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for portal vein tumor thrombus in patients with hepatocellular carcinoma].

Objective To study the influence of the sequence of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on the efficacy and toxicity of treatment in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods A total of 65 patients who were diagnosed with primary HCC with PVTT were enrolled in the study from November 2008 to March 2012 and were randomly divided into the following two groups: group A, 32 patients treated with 3DCRT followed by TACE; group B, 33 patients treated with TACE followed by 3DCRT. Results The total efficacy rates of groups A and B were 68.8% and 69.7% (χ2 = 0.232, P<0.793). The survival rates, effective percentage of PVTT and AFP remission rates were not significantly different between group A and group B. The exacerbation rate of liver function was significantly higher for group B than for group A (P<0.05). No serious complication was found in the follow-up period for either group. Conclusion The combination of 3DCRT and TACE is a relatively effective local treatment for patients with primary HCC and PVTT. Compared with TACE followed by 3DCRT, 3DCRT followed by TACE may have a negativeinfluence on liver function. Key words: Primary hepatocellular carcinoma; Portal vein tumor portal thrombus; Three dimensional conformal radiotherapy; Transcatheter arterial chemoembolization