Chai Hong Rim1, Chul Yong Kim2, Dae Sik Yang3, Won Sup Yoon4. 1. Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea. 2. Department of Radiation Oncology, Anam Hospital, Korea University Medical College, Seoul, Republic of Korea. 3. Department of Radiation Oncology, Guro Hospital, Korea University Medical College, Seoul, Republic of Korea. 4. Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea. Electronic address: irionyws@korea.ac.kr.
Abstract
PURPOSE: We performed a meta-analysis and systematic review to compare the radiotherapy (RT) modalities for hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT). MATERIALS AND METHODS: We searched the PubMed, EMBASE, Medline, and Cochrane library databases. The primary endpoint was the 1-year overall survival (OS), and response rate (RR), local control (LC), 2-year OS, and grade ≥3 toxicity incidence were evaluated as secondary endpoints. RESULTS: Thirty-seven studies comprising 2513 patients were included. The pooled 1-year OS rates for the 3-dimensional conformal RT (3DCRT), selective internal RT (SIRT), and stereotactic body RT (SBRT) groups were 43.8% [95% confidence interval (CI): 37.6-50.2], 46.5% (95% CI: 37.7-55.6), and 48.5% (95% CI: 39.4-57.8). These inter-group differences were not statistically significant (p = 0.635). The pooled response rates were 51.3% (95% CI: 45.7-57.0), 33.3% (95% CI: 18.0-53.2), and 70.7 (95% CI: 63.7-76.8) for 3DCRT, SIRT, and SBRT groups, respectively; p = 0.001 and 0.031 for 3DCRT vs. SBRT and SIRT, respectively. The most common grade ≥ 3 complications were lymphocytopenia and bilirubin abnormalities in the 3DCRT and SIRT groups, respectively. Grade ≥ 3 complication was rare in SBRT group. CONCLUSIONS: OS did not differ among the modalities, although the response rates vary among modalities.
PURPOSE: We performed a meta-analysis and systematic review to compare the radiotherapy (RT) modalities for hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT). MATERIALS AND METHODS: We searched the PubMed, EMBASE, Medline, and Cochrane library databases. The primary endpoint was the 1-year overall survival (OS), and response rate (RR), local control (LC), 2-year OS, and grade ≥3 toxicity incidence were evaluated as secondary endpoints. RESULTS: Thirty-seven studies comprising 2513 patients were included. The pooled 1-year OS rates for the 3-dimensional conformal RT (3DCRT), selective internal RT (SIRT), and stereotactic body RT (SBRT) groups were 43.8% [95% confidence interval (CI): 37.6-50.2], 46.5% (95% CI: 37.7-55.6), and 48.5% (95% CI: 39.4-57.8). These inter-group differences were not statistically significant (p = 0.635). The pooled response rates were 51.3% (95% CI: 45.7-57.0), 33.3% (95% CI: 18.0-53.2), and 70.7 (95% CI: 63.7-76.8) for 3DCRT, SIRT, and SBRT groups, respectively; p = 0.001 and 0.031 for 3DCRT vs. SBRT and SIRT, respectively. The most common grade ≥ 3 complications were lymphocytopenia and bilirubin abnormalities in the 3DCRT and SIRT groups, respectively. Grade ≥ 3 complication was rare in SBRT group. CONCLUSIONS: OS did not differ among the modalities, although the response rates vary among modalities.
Authors: Dominik Bettinger; David J Pinato; Michael Schultheiss; Rohini Sharma; Lorenza Rimassa; Tiziana Pressiani; Michela E Burlone; Mario Pirisi; Masatoshi Kudo; Joong Won Park; Nico Buettner; Christoph Neumann-Haefelin; Tobias Boettler; Nasrin Abbasi-Senger; Horst Alheit; Wolfgang Baus; Oliver Blanck; Sabine Gerum; Mathias Guckenberger; Daniel Habermehl; Christian Ostheimer; Oliver Riesterer; Jörg Tamihardja; Anca-Ligia Grosu; Robert Thimme; Thomas Baptist Brunner; Eleni Gkika Journal: Liver Cancer Date: 2018-07-12 Impact factor: 11.740