Tiffany Cl Wong1, Chi-Leung Chiang2, Ann-Shing Lee3, Victor Hf Lee4, Cynthia Sy Yeung3, Connie Hm Ho3, Tan-To Cheung1, Kelvin Kc Ng1, Siu-Ho Chok1, Albert Cy Chan1, Wing-Chiu Dai1, Frank Cs Wong3, Mai-Yee Luk4, To-Wai Leung4, Chung-Mau Lo5. 1. Department of Surgery, The University of Hong Kong, Hong Kong; Department of Surgery, Queen Mary Hospital, Hong Kong. 2. Department of Clinical Oncology, The University of Hong Kong, Hong Kong; Department of Clinical Oncology, Queen Mary Hospital, Hong Kong; Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong. 3. Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong. 4. Department of Clinical Oncology, The University of Hong Kong, Hong Kong; Department of Clinical Oncology, Queen Mary Hospital, Hong Kong. 5. Department of Surgery, The University of Hong Kong, Hong Kong; Department of Surgery, Queen Mary Hospital, Hong Kong. Electronic address: chungmlo@hku.hk.
Abstract
BACKGROUND: This study compared outcomes of nonresectable hepatocellular carcinoma (HCC) who had transarterial chemoembolization (TACE) vs. stereotactic body radiation therapy (SBRT) after TACE (TACE + SBRT). METHODS: This was a retrospective study of 2 centers in Hong Kong. There were 49 patients who had TACE + SBRT and 202 patients who had TACE alone. Propensity score matching was used to adjust for differences in patients' demographics and tumor characteristics between the 2 groups. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS) and treatment-related toxicity. RESULTS: After matching, 49 patients were in the TACE + SBRT group and 98 patients in the TACE group with similar baseline characteristics. The 1-&3-year OS were better in TACE + SBRT group (67.2 vs. 43.9% and 36.5 vs. 13.3%, p = 0.003). The 1-&3-year PFS was also better in TACE + SBRT group (32.5 vs. 21.4% and 15.1 vs. 5.1%, p = 0.012). Radiological disease control was better in the TACE + SBRT group (98 vs. 56.7%). Risk of severe toxicity was uncommon in both treatment arms. TACE + SBRT was an independent good prognostic factor for OS and PFS in multivariate analysis, whereas AFP>200 ng/ml, large tumor and multiple tumors predicted worse OS. CONCLUSION: TACE + SBRT is safe and results in better survivals in nonresectable HCC patients.
BACKGROUND: This study compared outcomes of nonresectable hepatocellular carcinoma (HCC) who had transarterial chemoembolization (TACE) vs. stereotactic body radiation therapy (SBRT) after TACE (TACE + SBRT). METHODS: This was a retrospective study of 2 centers in Hong Kong. There were 49 patients who had TACE + SBRT and 202 patients who had TACE alone. Propensity score matching was used to adjust for differences in patients' demographics and tumor characteristics between the 2 groups. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS) and treatment-related toxicity. RESULTS: After matching, 49 patients were in the TACE + SBRT group and 98 patients in the TACE group with similar baseline characteristics. The 1-&3-year OS were better in TACE + SBRT group (67.2 vs. 43.9% and 36.5 vs. 13.3%, p = 0.003). The 1-&3-year PFS was also better in TACE + SBRT group (32.5 vs. 21.4% and 15.1 vs. 5.1%, p = 0.012). Radiological disease control was better in the TACE + SBRT group (98 vs. 56.7%). Risk of severe toxicity was uncommon in both treatment arms. TACE + SBRT was an independent good prognostic factor for OS and PFS in multivariate analysis, whereas AFP>200 ng/ml, large tumor and multiple tumors predicted worse OS. CONCLUSION:TACE + SBRT is safe and results in better survivals in nonresectable HCC patients.
Authors: Ulrike Bauer; Sabine Gerum; Falk Roeder; Stefan Münch; Stephanie E Combs; Alexander B Philipp; Enrico N De Toni; Martha M Kirstein; Arndt Vogel; Carolin Mogler; Bernhard Haller; Jens Neumann; Rickmer F Braren; Marcus R Makowski; Philipp Paprottka; Markus Guba; Fabian Geisler; Roland M Schmid; Andreas Umgelter; Ursula Ehmer Journal: World J Gastroenterol Date: 2021-06-28 Impact factor: 5.742