Ting-Shi Su1, Ping Liang2, Jian Liang3, Huan-Zhen Lu4, Hua-Yan Jiang5, Tao Cheng4, Yong Huang5, Yang Tang4, Xin Deng3. 1. Department of Radiation Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China; Cyberknife Center, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. Electronic address: sutingshi@163.com. 2. Department of Radiation Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China; Cyberknife Center, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. 3. Department of Medical Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. 4. Cyberknife Center, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. 5. Department of Radiation Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Abstract
PURPOSE: To compare the efficacy of stereotactic ablative radiation therapy (SABR) versus liver resection for small hepatocellular carcinoma (HCC) ≤5 cm with Child-Pugh A cirrhosis. METHODS AND MATERIALS: This retrospective study included 117 patients with small HCCs with 1 or 2 nodules. Eighty-two patients received SABR (SABR group), and 35 patients underwent liver resection (resection group). Overall survival (OS) and progression-free survival (PFS) were analyzed. One-to-one matched pairs between the 2 groups were created using propensity score matching to reduce the potential confounding effect of treatment and selection bias. RESULTS: There was no between-group difference in OS and PFS. Before propensity score matching, the 1-, 3-, and 5-year OS was 96.3%, 81.8%, and 70.0% in the SABR group and 93.9%, 83.1%, and 64.4% in the resection group, respectively (P=.558). The 1-, 3- and 5-year PFS was 81.4%, 50.2%, and 40.7% in the SABR group and 68.0%, 58.3%, and 40.3% in the resection group, respectively (P=.932). After propensity score matching, 33 paired patients were selected from the SABR and resection groups. The 1-, 3-, and 5-year OS was 100%, 91.8%, and 74.3% in the SABR group and 96.7%, 89.3%, and 69.2% in the resection group, respectively (P=.405). The 1-, 3-, and 5-year PFS was 84.4%, 59.2%, and 43.9% in the SABR group and 69.0%, 62.4%, and 35.9% in the resection group, respectively (P=.945). There was a similarity of hepatotoxicity between the 2 groups. The SABR group showed fewer complications, such as hepatic hemorrhage, hepatic pain, and weight loss. Acute nausea was significantly more frequent in the SABR group than in the resection group. CONCLUSION: For patients with small primary HCC with 1 or 2 nodules and Child-Pugh A cirrhosis, SABR has local effects that are similar to those with liver resection. Stereotactic ablative radiation therapy has an advantage over resection in being less invasive.
PURPOSE: To compare the efficacy of stereotactic ablative radiation therapy (SABR) versus liver resection for small hepatocellular carcinoma (HCC) ≤5 cm with Child-Pugh A cirrhosis. METHODS AND MATERIALS: This retrospective study included 117 patients with small HCCs with 1 or 2 nodules. Eighty-two patients received SABR (SABR group), and 35 patients underwent liver resection (resection group). Overall survival (OS) and progression-free survival (PFS) were analyzed. One-to-one matched pairs between the 2 groups were created using propensity score matching to reduce the potential confounding effect of treatment and selection bias. RESULTS: There was no between-group difference in OS and PFS. Before propensity score matching, the 1-, 3-, and 5-year OS was 96.3%, 81.8%, and 70.0% in the SABR group and 93.9%, 83.1%, and 64.4% in the resection group, respectively (P=.558). The 1-, 3- and 5-year PFS was 81.4%, 50.2%, and 40.7% in the SABR group and 68.0%, 58.3%, and 40.3% in the resection group, respectively (P=.932). After propensity score matching, 33 paired patients were selected from the SABR and resection groups. The 1-, 3-, and 5-year OS was 100%, 91.8%, and 74.3% in the SABR group and 96.7%, 89.3%, and 69.2% in the resection group, respectively (P=.405). The 1-, 3-, and 5-year PFS was 84.4%, 59.2%, and 43.9% in the SABR group and 69.0%, 62.4%, and 35.9% in the resection group, respectively (P=.945). There was a similarity of hepatotoxicity between the 2 groups. The SABR group showed fewer complications, such as hepatic hemorrhage, hepatic pain, and weight loss. Acute nausea was significantly more frequent in the SABR group than in the resection group. CONCLUSION: For patients with small primary HCC with 1 or 2 nodules and Child-Pugh A cirrhosis, SABR has local effects that are similar to those with liver resection. Stereotactic ablative radiation therapy has an advantage over resection in being less invasive.
Authors: Kimberly L Shampain; Caitlin E Hackett; Sohrab Towfighi; Anum Aslam; William R Masch; Alison C Harris; Silvia D Chang; Kanika Khanna; Vivek Mendiratta; Ahmed M Gabr; Dawn Owen; Mishal Mendiratta-Lala Journal: Abdom Radiol (NY) Date: 2021-05-07
Authors: Siu Hin Mak; Sean Man Natalie Wong; Wan Hang Keith Chiu; Chi Leung Chiang; Wing Ling Winnie Yip; Hoi Man Connie Ho; Sin Yu Cynthia Yeung; Ka Heng Mark Chan; Wan Yan Venus Lee; Ann Shing Francis Lee Journal: Strahlenther Onkol Date: 2022-01-06 Impact factor: 4.033
Authors: Heather M McGee; Megan E Daly; Sohelia Azghadi; Susan L Stewart; Leslie Oesterich; Jeffrey Schlom; Renee Donahue; Jonathan D Schoenfeld; Qian Chen; Shyam Rao; Ruben C Fragoso; Richard K Valicenti; Robert J Canter; Emmanual M Maverakis; William J Murphy; Karen Kelly; Arta M Monjazeb Journal: Int J Radiat Oncol Biol Phys Date: 2018-04-22 Impact factor: 7.038