Objective: To investigate the efficacy, adverse reactions and influence factors of three-dimensional conformal/intensity modulated radiotherapy(3D-CRT/IMRT) for inoperable primary hepatocellular carcinoma(HCC). Methods: The clinic data of 45 patients with inoperable primary HCC who received 3D-CRT/IMRT in our hospital from July 2013 to May 2016 were retrospectively studied, including 12 patients with portal vein tumor thrombus, and 33 patients underwent transarterial chemoembolization (TACE) before radiotherapy. The short-term efficacy of the treatment was observed 1-3 months after radiotherapy. These patients were followed up for 1,2, and 3 years and the factors of influencing efficacy and prognosis were analyzed. Results: After radiotherapy, there were 4 cases (8.9%) complete remission(CR), 16 cases (35.5%) partial remission(PR), 17 cases (37.8%) stable disease (SD), and 8 cases progressive disease (PD) (17.8%) in primary liver leision. In the patients with venous thrombus, 1 case was CR(8.33%),3 cases were PR(25.0%),6 cases were SD(50.0%)and 2 cases were PD(16.67%). Objective remission rates of primary liver leision and venous thrombus after radiotherapy were 44.4%and 33.3%, respectively. During the radiotherapy, the adverse reactions more than Ⅲ degree were nausea and vomiting, myelosuppression, loss of appetite and fatigue. Factors influencing the efficacy of radiotherapy included tumor diameter, ΔCT value, prescription dose and ever received interventional therapy. The 1-year, 2-year and 3-year survival rates of the patients underwent 3D-CRT/IMRT were 59.8%, 40.9%and 2.22%, respectively. Multivariate analysis showed that tumor volume, tumor stage and tumor venous thrombus were the important factors affecting prognosis. Conclusion: 3D-CRT/IMRT is an effective method in the treatment of inoperable primary HCC with low adverse reactions and good tolerance. Tumor diameter, blood supply and radiotherapy dose are the key factors affecting the efficacy of radiotherapy on liver cancer, and tumor volume, stage and tumor thrombus are independent factors affecting the prognosis of patients. |