Better survival after stereotactic body radiation therapy following transarterial chemoembolization in nonresectable hepatocellular carcinoma: A propensity score matched analysis
| Autor: | Connie H. M. Ho, Frank Cs. Wong, Kelvin K. K. Ng, Victor Lee, Siu-Ho Chok, W.C. Dai, Cynthia S Y Yeung, Chi-Leung Chiang, To-Wai Leung, Albert Cy Chan, Tan To Cheung, T Wong, Mai-Yee Luk, Chung Mau Lo, Ann-Shing Lee |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Multivariate analysis Stereotactic body radiation therapy Radiosurgery Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient Chemoembolization Therapeutic Propensity Score Aged Retrospective Studies Aged 80 and over business.industry Liver Neoplasms Retrospective cohort study Middle Aged Prognosis medicine.disease Survival Rate Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma Baseline characteristics Propensity score matching Toxicity Female 030211 gastroenterology & hepatology Surgery business Follow-Up Studies |
| Zdroj: | Surgical Oncology. 28:228-235 |
| ISSN: | 0960-7404 |
| DOI: | 10.1016/j.suronc.2019.01.006 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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