Effect of combined body gamma-knife radiotherapy and thermotherapy on intermediate or advanced hepatocellular carcinoma in 25 patients

Objective To study the curative effect of combined body gamma-knife radiotherapy and whole body thermotherapy and micro-infusion pump chemotherapy on intermediate or advanced hepatocellular carcinoma （HCC）. Methods Twenty-five intermediate or advanced HCC patients with no contraindications for thermotherapy were included in the study. The patients were given 5-fluorouracil （1.0g）, hydroxycamptothecin （10mg）, and oxaliplatin （100mg） during thermotherapy, followed by intravenous oxaliplatin （100mg） on day 8. Two days later, the patients were given 5-fluorouracil （0.25g a day for 14 days） and hydroxycamptothecin （2mg a day for 9 days） through a micro-infusion pump. Body gamma-knife radiotherapy was performed 3 days after thermotherapy at a single dosage of 3.2-4.0Gy and a total dose of 36-44Gy according to the 50%-65% isodose line covering planning target volume. Chemotherapy was performed every two weeks, 4-6 weeks as a cycle. Thermotherapy was performed 1-3 times, once a month, on day 1 after chemotherapy. The toxicity, adverse reaction and short-term curative effect were observed after thermotherapy and body gamma-knife radiotherapy. Results Improvement was achieved in 22 patients, and the 1-year local lesion progression-free rate was 56% （14/25）. The 1- and 2-year survival rate was 76% （19/25） and 40% （10/25）, respectively. Local skin erythema on the lower limbs and abdomen, vesicles on skin and grade 1 acute adverse reaction occurred in 6, 2, and 1 patient, respectively, during the whole body thermotherapy. Conclusion Combined Body gamma-knife radiotherapy in combination with whole body thermotherapy and chemotherapy for HCC is safe and effective.