Survival benefit of higher fraction dose delivered by three-dimensional conformal radiotherapy in hepatocellular carcinoma smaller than 10 cm in size
| Autor: | Chunhua Wu, Zhong-Guo Liang, Fang Su, Xia Liang, Kai-Hua Chen, Yunli Yang, Long Chen, Ling Li, Song Qu, Xiao-Dong Zhu |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Urology Group A survival Group B higher fraction dose 03 medical and health sciences 0302 clinical medicine Medicine curative therapy Original Research business.industry hepatocellular carcinoma medicine.disease Thrombosis three-dimensional conformal radiotherapy Radiation therapy Transplantation 030104 developmental biology Oncology Cancer Management and Research 030220 oncology & carcinogenesis Hepatocellular carcinoma Propensity score matching business |
| Zdroj: | Cancer Management and Research |
| ISSN: | 1179-1322 |
| Popis: | Fang Su*, Kaihua Chen*, Zhongguo Liang, Song Qu, Ling Li, Long Chen, Yunli Yang, Chunhua Wu, Xia Liang, Xiaodong ZhuDepartment of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People’s Republic of China*These authors contributed equally to this workObjective: Even in early-stage hepatocellular carcinoma (HCC), patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult tumor location. To compare the safety and efficacy of different fractions on the survival of patients with tumors smaller than 10 cm in size, hepatocellular carcinoma (HCC) patients ineligible for curative therapies were treated with three-dimensional conformal radiotherapy (3DCRT).Methods: A total of 198 HCC patients who had tumors smaller than 10 cm and were not eligible for surgical resection or local ablation therapy received 3DCRT. Participants were separated into two groups. The treatment for Group A (n=111) was a median total dose of 53Gy with a fraction of 2.5–4.9Gy given three times a week, while treatment for Group B (n=87) was a median total dose of 52Gy with a fraction of 5.0–7.0 Gy given three times a week. Propensity score matching (PSM) was conducted, and after the PSM, 81 pairs of patients arose. The Kaplan–Meier method was adopted to analyze overall survival; multivariate analysis was applied to identify the prognostic factors of survival.Results: The median follow-up time was 19.7months (ranging from 1 to 186months). The median survival for Group A patients versus Group B patients was 14.4 versus 24.8months (P=0.003), respectively. The overall survival rates at 1, 3, and 5years were 57.7%, 30.6%, and 18.9% for Group A patients and 73.6%, 43.7%, and 33.3% for Group B patients, respectively (P=0.009). In addition, the results in the PSM model appeared to be similar between the two groups. After PSM, the association between four independent prognostic factors and worse overall survival was discovered as follows: tumor size (>5 cm), Child–Pugh class B, portal vein tumor thrombosis, and fraction of 2.5−4.9Gy/fx. The two groups also shared similar toxicities.Conclusions: Higher fraction dose radiotherapy delivered by 3DCRT was effective, as it offered a survival benefit without aggravating the toxicities in patients with small- to medium-sized HCC tumors who were ineligible for curative therapies.Keywords: three-dimensional conformal radiotherapy, higher fraction dose, hepatocellular carcinoma, curative therapy, survival |
| Databáze: | OpenAIRE |
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