Abstract
OBJECTIVE: To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) alone or in combination with radiotherapy or anlotinib for treating locally advanced hepatocellular carcinoma. METHODS: A retrospective analysis was conducted on 72 patients with locally advanced hepatocellular carcinoma, divided into three groups: TACE alone (n = 20), TACE + anlotinib (TACE+AH, n = 34), and TACE + intensity-modulated radiotherapy (TACE+IMRT, n = 18). TACE was administered every 30 days. For TACE+AH, patients received 12 mg of anlotinib daily for 14 days per cycle. TACE+IMRT involved 400-500 cGy radiotherapy sessions three times weekly, with a total dose of 5000-6000 cGy. RESULTS: No significant differences in Eastern Cooperative Oncology Group (ECOG) performance scores were observed among the groupspost-treatment. The TACE+IMRT group exhibited the highest objective response rate (ORR) (83.33%) and disease control rate (DCR) (88.89%). Progression-free survival (PFS) at 3, 6, and 12 months was also highest in the TACE+IMRT group, indicating superior outcome compared to the TACE+AH and TACE-alone groups. Independent predictors of PFS included the TACE+IMRT combination and Child-Pugh B grade. CONCLUSION: TACE combined with radiotherapy is a safe and effective treatment for locally advanced hepatocellular carcinoma, significantly improving PFS and serving as a protective factor. While TACE combined with anlotinib showed moderate efficacy and manageable adverse events, its therapeutic effect was less pronounced than that of TACE+IMRT.