Concomitant Chemoradiation Using Gemcitabine in Locally Advanced Hepatocellular Carcinoma

Abstract

Purpose: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Most of patients present with advanced disease that cannot be treated with curative or ablative intent. The aim of the study was to assess the therapeutic benefit of concurrent chemoradiotherapy (CCRT) in patients with advanced HCC and to identify factors that predict OS. Methods: Patients with radiologically or biopsy proven primary HCC from 2010 to 2013 were included in the study. Gemcitabine was given in a dose of 70 mg/m 2 once weekly for three weeks during external beam radiotherapy 30 Gy/2 Gy/fraction/five fractions per week in the Clinical Oncology Department, Assiut, Egypt. Results: Forty-nine patients were eligible but forty patients were evaluable for assessment. The partial response rate (PR) was 35% (14 patients), 16 patients (40%) had stable disease (SD) and the progressive disease was 25%. Painful hepatomegaly was significantly relieved in 70% of patients. Transaminases rose as grade 3 toxicity in 15% of patients. Longer overall survival (OS) was significantly observed in patients with performance status 0, child-Pugh A, Barcelona Clinic Liver cancer Stage B, PR and α fetoprotein level decrement. Conclusion: Concurrent chemoradiotherapt provides an acceptable response and palliation of pain in advances HCC. Our findings showed that better survival for patients with good performance and liver functions.