A comparison of carbon ion radiotherapy and transarterial chemoembolization treatment outcomes for single hepatocellular carcinoma: a propensity score matching study

Shintaro Shiba,Kei Shibuya,Hiroyuki Katoh,Tatsuya Ohno,Takashi Nakano,Masaya Miyazaki,Satoru Kakizaki,Takuya Kaminuma,Ken Shirabe

doi:10.1186/s13014-019-1347-4

Abstract

BackgroundWe compared clinical outcomes of carbon ion radiotherapy and transarterial chemoembolization in the treatment of hepatocellular carcinoma.MethodsData of 477 patients with hepatocellular carcinoma who had undergone carbon ion radiotherapy or transarterial chemoembolization between April 2007 and September 2016 were retrospectively reviewed. Treatment naïve patients with single HCC, who underwent carbon ion radiotherapy or transarterial chemoembolization as a primary treatment were included. Clinical outcomes of the treatments were compared after utilizing propensity score matching.ResultsOf 124 patients who received carbon ion radiotherapy and 353 patients who received transarterial chemoembolization, 31 and 23 patients met our inclusion criteria, respectively. After utilizing propensity score matching, 17 matched pairs of patients from each treatment group were analyzed. The median follow-up durations after carbon ion radiotherapy and transarterial chemoembolization were 43 and 32 months, respectively. The 3-year overall survival, local control, and progression-free survival rates in the carbon ion radiotherapy versus transarterial chemoembolization groups were 88% versus 58% (p < 0.05), 80% versus 26% (p < 0.01), and 51% versus 15% (p < 0.05), respectively.ConclusionsCarbon ion radiotherapy showed more favorable clinical outcomes than did transarterial chemoembolization for patients with single hepatocellular carcinoma after matching patient characteristics utilizing propensity score matching. Further studies with larger patient numbers are required to confirm our results.Trial registrationUMIN000036455: date of registration 22 March 2019, retrospectively registered.

Highlights

We compared clinical outcomes of carbon ion radiotherapy and transarterial chemoembolization in the treatment of hepatocellular carcinoma
transarterial chemoembolization (TACE) is the standard treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC), and TACE is considered one of the standard treatment options for patients with BCLC stage A who are ineligible for surgery and/or radiofrequency ablation (RFA) [1, 2]
Cion Carbon ion radiotherapy (RT) has been used as a form of therapy for localized HCC patients who are ineligible for surgery and/or RFA, and for patients who decline surgery and/or RFA, where such patients have usually been treated with TACE according to various guidelines [1, 11]

Summary

Introduction

We compared clinical outcomes of carbon ion radiotherapy and transarterial chemoembolization in the treatment of hepatocellular carcinoma. There are several treatment options for hepatocellular carcinoma (HCC) such as surgical resection, liver transplantation, percutaneous radiofrequency ablation (RFA), transarterial chemoembolization (TACE), molecular targeting therapy, and radiotherapy. Several studies have reported that 3year overall survival (OS) rates for patients treated with TACE for HCC were between 26 and 65% and that 2-year local control (LC) rates were between 28 and 41% [3,4,5,6,7,8,9]. Several studies have reported encouraging clinical outcomes, especially for patients with high rates of LC (3-year LC rates; 81–96%) after C-ion RT for HCC [12,13,14,15,16,17]

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