Data_Sheet_1_Stereotactic Body Radiation Therapy vs. Transarterial Chemoembolization in Inoperable Barcelona Clinic Liver Cancer Stage a Hepatocellular Carcinoma: A Retrospective, Propensity-Matched Analysis.PDF
Background and Objective: It is unclear if stereotactic body radiation therapy (SBRT) or transarterial chemoembolization (TACE) is better for the treatment of inoperable early-stage hepatocellular carcinoma (HCC). This study aimed to retrospectively compare the efficacy of SBRT to TACE in patients with inoperable Barcelona Clinic Liver Cancer (BCLC)-A stage HCC.
Materials and Methods: In this multi-institutional retrospective study, a total of 326 patients with inoperable BCLC-A stage HCC were enrolled. Totally, 167 patients initially received SBRT and 159 initially received TACE. Overall survival (OS), local control (LC), intrahepatic control (IC), and progression-free survival (PFS) were evaluated in univariable and propensity-score matched analyses.
Results: There was a smaller median tumor size in the SBRT group than in the TACE group (3.4 cm vs. 7.2 cm, P < 0.001). After propensity score matching in the selection of 95 patient pairs, SBRT had better LC, IC, and PFS than TACE but showed comparable OS. The accumulative 1-, 3-, and 5-year OS rates were 85.7, 65.1, and 62.8% in the SBRT group and 83.6, 61.0, and 50.4% in the TACE group, respectively (P = 0.29). The accumulative 1-, 3-, and 5-year PFS were 63.4, 35.9, and 27.5% in the SBRT group and 53.5, 27.4, and 14.2% in the TACE group, respectively (P = 0.049). The accumulative 1-, 3-, and 5-year LC were 86.8, 62.5, and 56.9% in the SBRT group and 69.3, 53.3, and 36.6% in the TACE group, respectively (P = 0.0047). The accumulative 1-, 3-, and 5-year IC were 77.3, 45.9, and 42.4% in the SBRT group and 57.3, 34.1, and 17.7% in the TACE group, respectively (P = 0.003). On multivariate analysis, treatment (SBRT vs. TACE) was a significant covariate associated with local and intrahepatic control (HR = 1.59; 95% CI: 1.03–2.47; P = 0.04; HR = 1.61; 95% CI: 1.13–2.29; P = 0.009).
Conclusions: SBRT was an alternative to TACE for inoperable BCLC-A stage HCC with better local and intrahepatic control. Controlled clinical trials are recommended to evaluate the actual effects of this novel regimen adequately.
History
References
- https://doi.org//10.1016/j.jhep.2011.12.001
- https://doi.org//10.1016/S0140-6736(02)08649-X
- https://doi.org//10.1053/jhep.2002.33156
- https://doi.org//10.1016/j.jhep.2012.01.008
- https://doi.org//10.1053/j.gastro.2006.05.021
- https://doi.org//10.6004/jnccn.2017.0059
- https://doi.org//10.1002/jso.24128
- https://doi.org//10.1186/1471-2407-10-475
- https://doi.org//10.1200/JCO.2012.44.1659
- https://doi.org//10.1016/j.ijrobp.2011.04.011
- https://doi.org//10.1016/j.ijrobp.2017.02.095
- https://doi.org//10.1200/JCO.2015.61.4925
- https://doi.org//10.2147/OTT.S51452
- https://doi.org//10.1002/cncr.30008
- https://doi.org//10.1186/s12885-016-2894-9
- https://doi.org//10.1111/hpb.12331
- https://doi.org//10.1159/000488035
- https://doi.org//10.1016/j.amjsurg.2018.07.054
- https://doi.org//10.1016/j.radonc.2018.02.031
- https://doi.org//10.1055/s-0030-1247132
- https://doi.org//10.1002/pst.433
- https://doi.org//10.1016/j.ijrobp.2017.09.001
- https://doi.org//10.1016/j.jhep.2017.02.022
- https://doi.org//10.1007/s00270-011-0224-9
- https://doi.org//10.1371/journal.pone.0077472
- https://doi.org//10.3109/0284186X.2013.820342
- https://doi.org//10.1016/j.radonc.2015.04.006
- https://doi.org//10.1038/bjc.2013.85
- https://doi.org//10.1016/j.ejso.2004.10.011
- https://doi.org//10.1007/s00270-009-9750-0
- https://doi.org//10.1007/s00270-009-9711-7
- https://doi.org//10.1200/JCO.2015.64.0821
- https://doi.org//10.1053/j.gastro.2016.08.029
- https://doi.org//10.1016/j.radonc.2018.12.013
- https://doi.org//10.1002/hep.30591
- https://doi.org//10.1371/journal.pone.0206381
- https://doi.org//10.1177/1533033818783450
- https://doi.org//10.1186/s12885-019-5461-3
CC BY 4.0