Comparison of radiation doses between hepatic artery infusion chemotherapy and transarterial chemoembolization for liver cancer

OBJECTIVE: To analyze the radiation dose received by patients during hepatic artery infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) procedures and the related influencing factors. METHODS: Data of 162 cases in the HAIC group and 230 cases in the TACE group were collected. The included covariates were Age (<45/45–59/≥60 years), BMI levels (underweight/normal weight/obesity), focus Dye of tumor (present/absent), lesion size (<5cm/≥5cm), superselection (present/absent), hepatic vascular variation (present/absent). The endpoints were postoperative dose-area product (DAP), exposure time and Air kerma (AK). RESULTS: Of all included patients, the HAIC group patients were younger than those in the TACE group (P ​= ​0.028). The proportion of patients with large lesions in the HAIC group was higher than the TACE group (45.7% vs. 33.9%, P ​= ​0.019). The proportion of patients who had superselection was lower in the HAIC group as compared to the TACE group (61.7% vs. 82.2%, P ​< ​0.001). Generally, the HAIC group has lower DAP, exposure time and AK by 36.3% (P ​< ​0.001), 38.2% (P ​< ​0.001), and 41.3% (P ​< ​0.001) than the TACE group, respectively. Linear regression analysis showed the procedure method (HAIC/TACE, P ​< ​0.001), type of DSA machine (Pheno/FD20, P ​< ​0.001), BMI levels (P ​< ​0.001), age (P ​= ​0.021), lesion size (<5cm/≥5 ​cm, P ​= ​0.031) significantly correlated with low DAP. In the HAIC group, the type of DSA machine and BMI correlated with the radiation dose, while in the TACE group, the type of DSA machine, BMI, and lesion size correlated with the radiation dose. CONCLUSION: Compared with TACE, HAIC enables doctors and patients to receive lower radiation doses. Obese patients in both HAIC and TACE groups increase the radiation exposure in interventional doctors and patients, but large lesions only affect the radiation dose in the TACE procedure.