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Combination treatment effective in patients with hepatocellular carcinoma
Editor’s note: In April 2009, JAMA editors retracted this study due to concerns about the integrity of the data.
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In patients with hepatocellular carcinoma larger than 3 cm, a combination of transarterial chemoembolization and radiofrequency ablation therapy is superior to either method alone in survival improvement.
To determine survival benefits of the combination, researchers from China randomly assigned 291 patients to combined transarterial chemoembolization-radiofrequency ablation therapy (n=96), transarterial chemoembolization alone (n=95) or radiofrequency ablation therapy alone (n=100) from January 2001 to May 2004.
Death rates were 84% in both monotherapy groups, and 69% in the combined group. According to the researchers, the combined group had fewer deaths due to tumor progression than in either monotherapy group.
Compared with those patients assigned to either monotherapy, patients assigned to combination therapy had better overall survival. Median survival was 24 months after a mean 3.4 treatments in the transarterial chemoembolization group; 22 months after a mean 3.6 treatments in the radiofrequency ablation therapy group; and 37 months after a mean 4.4 courses in the combination therapy group.
Six-month sustained objective response rate was also higher in the combination group (54%) than the transarterial chemoembolization (35%) or radiofrequency ablation therapy (36%) groups. – by Stacey L. Adams
JAMA. 2008;299:1669-1677.