Abstract No. 547 Radioembolization segmentectomy and stereotactic body radiation therapy for hepatocellular carcinoma: a retrospective survival analysis

Abstract

To compare outcomes among hepatocellular carcinoma (HCC) patients treated with radioembolization segmentectomy (RS) with yttrium-90 conjugated beads or stereotactic body radiation therapy (SBRT). This single-center retrospective study included all HCC patients treated with RS or SBRT from January 2010 to February 2016. Records were reviewed for sex, median age (MA), target tumor size (cm) (TS), prior local-regional therapy with transarterial chemo embolization and/or ablation (LRT), radiographic response progression, and overall survival time (OST). Kaplan Meier and Cox multivariate regression survival analysis were performed to determine time to local progression (TLP), time to overall disease progression (TOP), and OST (months) after RS or SBRT along with hazard ratio (HR). There were 51 RS patients (75% male, MA 66) and 71 SBRT patients (75% male, MA 64) included. When TS was restricted to ≤5 cm, there were 23 RS patients (78% male, MA 64) and 64 SBRT patients (72% male, MA 65). Kaplan Meier revealed for all RS and SBRT respectively: TLP (34.6 v 54.8, p<0.04), TOP (19.1 v 27.6, p = 0.15), and OST (33.4 v 55.6, p = 0.48). Mean TS for RS and SBRT was 5.4 v 3.4, p<0.01. Rates of prior LRT in RS and SBRT were 25% v 87% (p<0.01). Multivariate regression survival analysis including treatment type, sex, age, prior LRT, and TS (Table 1) demonstrated that TS was the only independent predictor of TLP, TOP, and OST. When TS for RS and SBRT was limited to ≤5 cm (mean TS 3.3 v 2.6, p = 0.13), Kaplan Meier revealed respectively: TLP (39.3 v 55.6, p = 0.47), TOP (25.3 v 27.4, p = 0.83) and OST (38.3 v 50.0, p = 0.92). Retrospective analysis demonstrates RS and SBRT have similar outcomes in HCC with TS ≤ 5 cm and the majority of SBRT patients had prior LRT. TS may be an important factor in selecting RS and SBRT with LRT.Table 1Cox Regression AnalysisTLP HR (p)TOP HR (p)OST HR (p)RS v SBRT0.4(0.14)0.6(0.15)1.7(0.40)Sex0.3(0.11)0.6(0.16)1.1(0.91)Age1.0(0.70)1.0(0.66)1.0(0.47)LRT2.2(0.24)1.9(0.15)0.4(0.16)TS1.2(<0.01)1.3(<0.01)1.2(<0.01)P model<0.01<0.03<0.05 Open table in a new tab