Chemoembolization Combined with RFA for HCC:Survival Benefits and Tumor Treatment Response

Renumathy Dhanasekaran, Vinit Khanna, David A. Kooby, John S. Kauh, John D. Carew, Hyun S. Kim

Biostatistics, Winship Cancer Institute, Emory University School of Medicine, Atlanta, USA.
Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, USA.
Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, USA.
Surgery, Emory University School of Medicine, Atlanta, USA.

DOI: 10.4236/jct.2013.42060                

Abstract

Purpose: To investigate survival benefits and tumor treatment response among patients who received treatment with transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone. Materials and Methods: A total of 108 HCC patients were treated with TACE between the period of 1998 and 2008. 51 (47.2%) received TACE followed by planned RFA and 57 (52.8%) received TACE alone. 57 patients received Precision TACE with Doxorubicin drug eluting beads and 51 received conventional TACE. Survival analysis was performed using Kaplan Meier Estimator with a log rank test, Fischer exact test was performed for categorical variables and the t test for continuous variables. Results: Mean MELD (Model for End Stage Liver Disease) score among the TACE-RFA and TACE-only groups were 12.87 and 12.33 respectively (p = 0.64). The number of patients in Child’s Class A, B, C in the two groups were 28/15/8 and 23/23/11 (p = 0.30); in Okuda Class I, II and III in the two groups were 22/23/6 and 14/30/9 (p = 0.2). Median survival among patients who received TACE-RFA and TACE alone were 566 days and 209 days (p = 0.01). Median survival of patients treated with Precision-TACE + RFA was 566 days and that of patients treated with conventional TACE + RFA was 336 days (p = 0.510). Mean progression-free duration by RECIST criteria among the TACE + RFA group was 210 days vs. TACE only group 97 days (p = 0.04). Conclusion: Combination therapies of TACE and RFA were associated with improved overall survival than TACE alone. Patients with single tumors <5 cm appeared to have a survival advantage with combination therapy when compared to larger tumors. TACE-RFA was associated with improved tumor response and progression-free duration than TACE alone.

Keywords

TACE; RFA; Survival; RECIST

Conflicts of Interest

The authors declare no conflicts of interest.

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