Transarterial chemoembolization combined with radiofrequency ablation therapy has been used for patients with large hepatocellular carcinoma tumors.
The survival benefits of combined treatment are not known.
|The rate of objective response was 54% with combination treatment|
|Journal of the American Medical Association|
Dr Bao-Quan Cheng and colleagues from China compared rates of survival of patients with large hepatocellular carcinoma tumors.
The research team conducted a randomized controlled trial from 2001 to 2004 among 291 consecutive patients with hepatocellular carcinoma larger than 3 cm at a single center in China.
Patients were randomly assigned to treatment with combined transarterial chemoembolization-radiofrequency ablation, transarterial chemoembolization alone, or radiofrequency ablation alone.
The team's primary end point was survival, and the secondary end point was objective response rate.
The researchers found that during a median 29 months of follow-up, median survival time was 24 months in the transarterial chemoembolization group.
Median survival was 22 months in the radiofrequency ablation group, and 37 months in the transarterial chemoembolization-radiofrequency ablation group.
Patients treated with transarterial chemoembolization-radiofrequency ablation had better overall survival than those treated with transarterial chemoembolization alone.
In a preplanned substratification analysis, survival was also better in the transarterial chemoembolization-radiofrequency ablation group than in the radiofrequency ablation group for patients with uninodular hepatocellular carcinoma.
The team noted improved survival in the transarterial chemoembolization-radiofrequency ablation group than in the transarterial chemoembolization group for patients with multinodular hepatocellular carcinoma.
The rate of objective response sustained for at least 6 months was higher in the transarterial chemoembolization-radiofrequency ablation group.
The rates of objective response was 54% with combination treatment, 35% with transarterial chemoembolization, and 36% with radiofrequency ablation treatment alone.
Dr Chengs' team concluded, "In this patient group, transarterial chemoembolization -radiofrequency ablation was superior to transarterial chemoembolization alone or radiofrequency ablation alone in improving survival for patients with hepatocellular carcinoma larger than 3 cm."